X-ray remains the foundation of medical imaging, but like any technology, it comes with challenges and opportunities for innovation. In this interview, Dr. Philip Templeton, Radiologist and Chief Medical Officer at KA Imaging, discusses the lasting importance of X-ray, the rise of mobile imaging, the limitations of traditional systems, and how advancements like SpectralDR are enhancing diagnostic capabilities.
Q: Is X-ray still important?
Phil Templeton: It’s absolutely going to be the mainstay. It is really the first and easiest line of defense when you’re evaluating someone with pulmonary cough or pneumonia. Certainly, COVID has shown how important that was. It’s going to be the mainstay when someone injures themselves and you want to know if they’ve fractured a bone. It’s going to be the first thing that happens when someone comes into the emergency room with trauma, which could involve multiple body parts, and they need to figure out where to focus. So, you know, X-ray is here to stay. It’s not going anywhere.
Q: What is the importance of mobile X-ray?
Phil Templeton: First of all, in the hospital, mobile X-ray is used quite frequently because many patients can’t travel—either because they’re in intensive care units, cardiac care units, or post-operative recovery. They may have too many devices hooked up to them. So, the techs are always going out to do mobile X-rays for those patients.
But there’s also been a real expansion of imaging at home, so-called mobile healthcare. Many patients now have doctors and X-ray machines coming to their homes to image them rather than having to go to the hospital. That segment really exploded during COVID because nobody wanted to go near hospitals or healthcare facilities due to the fear of contracting COVID.
Another key area in the hospital is the operating room. While performing surgery, doctors may need to check the positioning of devices they’ve placed or ensure they haven’t left any instruments inside. So, there are many reasons why mobile imaging is important.
Q: What are the challenges of traditional X-ray?
Phil Templeton: One important factor in any image is the radiologic technologist’s ability to position the patient correctly and use the right exposure settings to obtain the optimal image. They play a critical role. But once we have the image, there are plenty of challenges.
Some people say reading a chest X-ray is one of the hardest things we do in radiology. Unlike cross-sectional imaging, everything overlaps in a single chest image—all the soft tissues, muscles, bones, and devices on or inside the patient. We really have to scrutinize the image because lesions could be hiding behind bones, such as the clavicle or a rib. We do our best to detect these abnormalities.
The patient also plays a factor. If they can walk in, stand up, follow instructions, and hold their breath, the images tend to be high quality. But when they are less able to cooperate due to physical or cognitive disabilities, or if they are bedridden and positioned awkwardly, interpretation becomes much harder.
Q: What is the role of SpectralDR?
Phil Templeton: To be frank, X-ray has its limitations, as we mentioned. SpectralDR gives us two additional views of the body. In the chest, for example, it removes the bones covering the thorax, allowing us to see underneath them. That is really important and useful. The second view is the bone image—since overlapping shadows often obscure bones, this view provides a much clearer perspective.
It really helps us make subtle diagnoses, especially when findings are hidden behind bones or medical devices. It’s amazing how many infusion ports, lines, tubes, pacemakers, and other things can obscure lung findings. With the SpectralDR lung image, these elements are removed, allowing us to see what’s behind them. In every single case, having these additional two images is an enormous benefit.
Q: What are the benefits for different stakeholders?
Phil Templeton: There are different types of benefits. For the technologist, repeat X-rays are sometimes needed because something couldn’t be seen or a patient was rotated, making it difficult to see behind certain structures. With these additional images, the radiologist may get the necessary information without requiring a repeat exam. That saves a lot of time and effort.
For the radiologist, it makes reading easier. Whether it’s assessing lines and tubes—where we always try to locate the tip—or identifying subtle airspace disease in an immunocompromised patient, these extra images provide clarity. This may also help us avoid unnecessary CT scans, allowing for earlier detection with X-ray alone.
Every stakeholder benefits. Even from a financial and institutional perspective, SpectralDR imaging enables early detection of coronary calcium, which is now a major focus in cardiovascular health. Many people undergo CT scans specifically for calcium scoring, but with SpectralDR, we can incidentally detect coronary artery disease during routine imaging. If a patient comes to the emergency room for a cough or chest pain, and we potentially identify coronary calcifications, they can begin a cardiac workup early. This benefits the patient through early detection and benefits the institution by driving follow-up studies and treatments.
Q: What are the obstacles to adoption?
Phil Templeton: In medicine, as in many fields, people can be slow to change or think, “What I have works, so why do I need something new?”
Some of it is just familiarity—clinicians may have used the same company’s DR plates for years. But switching to SpectralDR isn’t actually a big change. The plate works in the same machines and integrates into the same workflow; it just provides more information. So, it’s really about shifting mindsets.
People should realize that dual-energy subtraction has been around for a long time, but it wasn’t widely accessible. All the research studies on it have consistently shown that it is superior to traditional X-ray. It benefits everyone in healthcare—providing better diagnoses, more accurate information, faster treatment, and easier interpretation for radiologists. Ultimately, it’s just about getting people to recognize these advantages and embrace the change.