Comparison of CR and DR

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Table of Contents

Computed radiography (CR) & digital radiography (DR) have become unbelievably prevalent in imaging facilities worldwide. To make the most out of these two advanced digital imaging systems, radiologists and radiographers must have high-bandwidth web facilities and reliable computer networks.

In this write-up, we’re going to dive deeper into digital radiography vs. computed radiography and discuss all you need to know about these two radiography systems.

What Does CR Stand For In Radiology?

CR stands for computed radiography.

About Computed Radiography Technology

Computed radiography (CR) is a type of radiography system that involves replacing the conventional X-ray film with a flexible phosphor Imaging Plate (IP) to take a digital image. Some people also refer to it as “film replacement technology.”

CR scan of a patient in a hospital.

How Computed Radiography Works

Computed radiography is a little bit like traditional radiography that was based on film, only that it is digitized. It requires cassette-based phosphor storage plates (PSP), scanned into a digital format to facilitate the processing, archiving, and representation of images.

So, this is what happens during computed radiography. Radiologists or doctors take an X-ray (from the X-ray equipment) onto a cassette and place the latter into a CR reader for digital scanning. Afterward, the reader shows the scanned digital image on the screen so that it can be viewed and manipulated if necessary. In simpler terms, the x-ray is shot, scanned, and read using the machine known as the CR reader.

Here are a few more things that you should note about Computed Radiography (CR).

For starters, the cassettes used in computed radiography work like the regular film cassettes. Even so, the two are not entirely similar because a CR cassette comes with a phosphor plate that can be reused for as many as ten thousand times. A CR cassette can come in many different specialized and standard sizes, including 14″x17″ and 10″x12″. One of the reasons it can last for an incredibly long time is that it doesn’t need to be opened often, and this also increases the durability of the imaging plate.

Additionally, you should understand that the CR reader’s primary function is to scan the phosphor plate (from a cassette). Most readers available today can also erase the plate and re-insert it into the cassette after the previous image has been scanned and viewed. CR readers are not all the same. Each comes with its distinct features, including the number of phosphor plates it can accommodate simultaneously, its scanning speed, and its size and shape.

Again, every digital image that is scanned through CR can be sent to the workstation. In this case, the latter refers to a standard computer that has specialized software. Doctors can view the images whenever they want, change and even share them when need be.

The dr is examining the x-ray using digital radiography (DR).

What is DR?

Digital radiography (DR) is a unique kind of ultra-modern X-ray inspection used by imaging facilities today to generate instant radiographic images on computers.

How does Direct Digital Radiography Work?

Direct digital radiography involves the direct transformation of absorbed X-ray energy resolution into various electrical charges that are proportionally sized. This process occurs within a semi-conductor without any intermediate scintillating step.

Radiologists prefer direct digital radiography because it has a considerably high modulation transfer function (MTF), resulting in high-quality digital images.

What are the Types of Digital Radiography?

There are two types of digital radiography. The first one is computed radiography (CR), which involves the use of photostimulable phosphor plates (PSP) inserted in cassettes. The other one is direct digital radiography (DDR), which most people refer to as direct radiography (DR). No cassettes are used in DR, plus it can be direct or indirect.

When was Digital Radiography Introduced?

Digital radiography was started in the 1980s after the X-ray discovery by Professor Wilhelm Conrad Röntgen in 1985.

Retrofit Upgrade

Getting DR retrofit solutions could be the perfect way for organizations to reap all the fantastic benefits of direct DR and leave CR systems behind. The transition from CR to DR can be smooth and cost-effective, mainly because various DR retrofit solutions are available on the market today.

For instance, Some equipment manufacturer offers DR room and mobile retrofit systems that feature Flat Panel Detectors and wireless table operation to gift doctors with unlimited freedom. These DR retrofit solutions are also rechargeable and self-powered.

Difference between Computed Radiography and Digital Radiography

There are several differences between computed radiography and digital radiography. These include the following.

Steps Involved

The steps involved in CR are a little different from those involved in DR. With the former, the steps the radiographer must follow are:

  • Prep the room
  • Load the CR cassette
  • Position the patient, followed by the tube
  • Perform exposure
  • Remove the cassette and load into reader for processing
  • Evaluate the image quality before concluding the appointment
In digital imaging (DR), below are the steps to follow:
  • Prep the room
  • Position the patient
  • Position the tube
  • Exposure

Analyze image quality before appointment conclusion

Note that the requirement of loading cassettes into reader in computed radiography (CR) is the leading cause of the difference between these two digital imaging systems.

Step titer - gr & dr.

Initial Investment and Maintenance Costs

CR comes with a lower initial investment cost as compared to DR. Even so, the cost of maintaining CR systems is way higher than that of taking care of DR systems. This is partly because CR systems are more susceptible to damage for both image plate and reader.


While it is possible to install CR systems in existing machines, DR systems require a completely new setup. This explains why the initial installation of a DR system is higher than that of a CR system.

Time Consumption

CR is more time-consuming than DR. This is because, with the former, the CR cassette has to be put into the reader and transferred later on, unlike the latter, which comes with an almost immediate image.

Image Quality

DR provides a better image quality than CR. The reason behind it is that DR systems have a digital detector that points out every detail of the digital images, unlike CR systems, whose image quality can even reduce during processing in the cassette.

Scanning Speed

DR comes with a fast patient throughput due to the digitized setup, making it possible for the system to scan the images in ten seconds. This is dissimilar to CR, whose patient throughput is slow, meaning that the digital images can wait for up to three minutes or more to be ready for viewing. As CR need time to process the image by the reader.


DR systems have more than a million exposures. Combined with their low portability, these digital imaging systems are more durable than CR systems that are prone to fast image plate deterioration and high portability, making them easy to be destroyed.

infographic of benefits of switching CR to DR

Advantages of Digital Radiography over Computed Radiography

Digital radiography offers some perks that doctors using computed radiography do not get to enjoy. First, DR has an entirely digitized setup that allows radiographers to scan images faster, unlike CR, whose need to move the cassette leads to labor intensiveness. This also means that DR saves on time and promotes more productivity.

Additionally, DR systems are pretty easy and affordable to maintain, which is far from CR systems. Owning a DR system enables a doctor to scan quality digital images at a lower cost while spending less time on labor.

In addition to that, digital radiography provides better images than computed radiography. This makes it possible for radiologists using DR to be more efficient, especially during image analysis.

Other advantages of a DR system over a CR system are:
  • Less bulkiness
  • More reliability due to high efficiency
  • Easier to use thanks to the digitized setup

What Are the Disadvantages of Digital Radiography?

Despite all the benefits that come with digital radiography, this digital imaging system has a few downsides, as with all things. For instance, DR systems are less portable. This makes it extremely challenging to acquire images from all views, especially awkward ones. Furthermore, purchasing DR systems is costly, and imaging organizations looking to enjoy their benefits have to invest a lot of money. Even so, getting DR retrofit could help them minimize the cost required.

Why DR is a Better Choice

After doing a CR vs. DR analysis, clearly, DR is the better pick. This is because it allows for faster acquisition of quality images. Besides, digital radiography comes with low imaging failure rates, meaning that the patient exposures are also reduced. On top of that, DR allows for high-speed workflow, meaning that imaging companies or hospitals can be more productive with DR systems.

Why you Need to Upgrade in Malaysia

In 2018, the Foreign Workers Medical Examination Monitoring Agency (Fomema) came up with an initiative to advocate for the production of all Malaysian foreign worker X-ray films in digital format. Undoubtedly, this was a good move. With such an upgrade in Malaysia, foreign employees and other residents would be able to access better screening services, promoting their health and eventually improving the quality of their lives.

X-ray monitors displaying digital radiography and computed radiography images.

Digitalization Is Part Of The Industry 4.0

Digitalization in the radiography industry in Malaysia is inevitable. It is encouraged by Industry 4.0, which is characterized by the cyber-physical transformation of how things are produced. 

In Malaysia, this migration to digital radiography will be supported by both private and government X-ray facilities as promoted under Health 4.0 blue print.

Hopefully, you now understand digital radiography (DR) and computed radiography (CR) and why most radiologists prefer the former to the latter. With the many technological advancements being made, DR systems become more efficient and popular every day. The radiography system paves the way for massive productivity and allows organizations to save on maintenance costs while meeting their various patients’ X-ray needs.

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