Medical imaging table – how to choose the best one?
18 February 2025
A medical imaging table is far less often the subject of a tender process conducted by medical institutions than a standard surgical table. However, recent years have seen a definite change in attitude towards this subject, and that on a global scale. Today, the X-ray C-arm is already an essential piece of equipment for every hospital. The increasing availability of X-ray machines and their technological advancements are resulting in an increased demand for tables and accessories transparent to X-rays. A medical imaging table can have many elaborate features and functionalities to consider when choosing medical equipment. There are a number of models to choose from that feature a fixed height or no longitudinal tilt. There are also those that have a full range of adjustment and a horizontally sliding tabletop. One can also choose a standard surgical table, but is it worth it? So, let’s see how to choose a medical imaging table so that it helps in work, rather than being a hindrance.
Medical imaging table with a dedicated mattress
Let’s start with a not-so-obvious aspect and look at the mattress that a medical imaging table should be equipped with. What is the obstacle of a mattress when performing X-rays? We asked this question to experts from Famed Żywiec. The Polish medical equipment manufacturer has come to a clear conclusion when testing its designs:
– The X-ray translucency parameter for a tabletop alone and for a tabletop with a polyurethane mattress differs by as much as 92%. The surface on which the patient is positioned significantly affects the quality of imaging and the amount of dose that the X-ray C-arm emits. When a medical imaging table is equipped with a foam mattress, the X-ray attenuation parameter will increase by as much as 152%. These are the facts – says Michał Grossy, Product Manager at Famed Żywiec.
If you do not have to opt for a standard surgical table, it is best to choose a medical imaging table. A tabletop and mattress adapted to work with X-rays will help reduce radiation and improve image quality.
Poles are concerned about the harmful effects of X-ray radiation
According to the survey “Poles about X-rays” conducted in 2014 by TNS OBOP at the request of Phillips, as much as 49% of respondents would be willing to pay extra for an examination to reduce the impact of X-rays on their body. For 90% of respondents, radiation dose, radiation protection and the frequency of X-ray examinations are important issues. Adverse effects of radiation (41%) and the obsolescence or lack of equipment in Polish hospitals (39%) were the most frequently cited risks and difficulties associated with X-ray procedures. The results of the survey indicate that Poles are optimistic about the development of new technologies in medicine. A total of 73% of respondents are aware that the level of technological advancement of equipment for this type of examination has an effect on their health and life[1].
Safety during medical imaging
Let’s take into account the fact that a patient is exposed to radiation only during a single examination procedure or surgery. When striving to reduce the harmful effects of imaging using X-ray, main attention is paid to medical staff. It is their well-being that should be taken into account when choosing a medical imaging table. The goal of all manufacturers of medical devices for X-ray surgery is to reduce the radiation dose. IIs it possible to choose a safe medical imaging table that does not negatively affect the quality of the received X-ray images? Definitely, yes.
Carbon fibre top
In most cases, a medical imaging table is equipped with a single-section carbon fibre top. Designs of that type prioritise better translucency and safety over ease of patient positioning. Obviously, each physician has own preferences and it is not our role to choose the way of patient positioning for the physicians. However, from our observations, the vast majority of surgeries in the catheterisation room or minimally invasive surgeries are performed in a fairly standard position – lateral, supination or pronation. The requirements for other ways of patient positioning during procedures using, e.g., the X-ray C-arm will make it possible for us to obtain the appropriate positioners.
Famed FLARE medical imaging table with a solid carbon tabletop made using TotalClear™ technology..
Medical imaging table and tabletop translucency parameter
A medical imaging table with a carbon fibre top provides a minimal barrier to X-ray radiation. However, the quality of such a tabletop can vary significantly depending on the model. A generally recognised, even considered critical translucency value, is an aluminium equivalent coefficient of less than 1 mm. The values from 0.4 to 0.6 mm AI are considered optimal. This parameter is information on the quality of the medical imaging tabletop, its barrier to X-ray radiation and its possibility of reduction of the dose applied to the patient and staff by, e.g. the X-ray C-arm. The Famed FLARE medical imaging table is the undisputed leader here. In 2019, the Polish manufacturer of medical equipment, Famed Żywiec, set a world record for tabletop translucency at the level of 0.36 mm AI. In 2021, it broke its own record by setting it at 0.33 mm AI[2].
The Famed FLARE medical imaging table and the X-ray C-arm enable 360° imaging..
Comparative studies
Based on the study by Famed Żywiec, FLARE medical imaging table reduced the transmitted radiation dose by as much as 10%. It should be remembered that for most operations, the number of such images can be multiplied tens, hundreds or thousands of times. The GE OEC Elite CFD C-arm and the upper limb of a patient with a radius shaft fracture (S52.3) repaired with an ORIF plate were used for the study. The limb was placed on the tabletop at a distance of 38 cm from the image intensifier in the C-arm. The X-rayed object was placed exactly in the centre of the frame. The device showed a dose of 0.0077 Gycm2 (0.0175 mGy) for the Famed FLARE table and 0.0085 Gycm2 (0.0193 mGy) for an imaging table of another leading brand, which was the object of comparison[3]
Expert opinion
— The study showed that imaging on the Famed FLARE table required a lower radiation dose than in the case of another model of the operating table that was the object of comparison. This is very important for the safety of performed procedures, as it is possible to reduce the radiation dose for the patient and staff. Lower X-ray exposure for staff and patients reduces the risk of radiation-related lesions – says prof. dr. hab. n. med. Piotr Kulakowski from the Cardiology Clinic, CMPK, Grochowski Hospital in Warsaw[4]..
The translucency parameter, expressed in aluminium equivalent, is information on the quality of the tabletop for medical imaging, its barrier to X-ray radiation and its possibility of reduction of the dose applied to the patient and staff.
Surgical table or medical imaging table?
Obviously, one can also choose a standard surgical table — it also has an X-ray transparent top. Before deciding on such a purchase, one should bear in mind a few limitations and differences. Firstly, it should be remembered that the materials used to manufacture surgical tabletops have varying degrees of translucency. Secondly, a surgical table with a top equipped with steel obstructions limiting the imaging window will be of no use, even if it is a carbon fibre top. In this case, the problem will be the length of the imaging window and the limited access for the X-ray C-arm. Metal reinforcements and slats will make imaging from the side or 3D imaging impossible. A medical imaging table, such as the Famed FLARE, has a 360° transparent top with a length of almost two meters. This allows contrast to be tracked along virtually the entire length of the human body.
The surgical table has metal reinforcements that make the imaging window smaller and prevent 3D and 360° imaging.
Portable or stationary medical imaging table
A medical imaging table may enable rapid movement around the hospital or may be permanently attached to the floor. Choosing the right option depends on the preference of the hospital staff. However, it is always necessary to take into account the possibility of a better response to changes in the characteristics of the operating theatre. Also, technological progress and quantitative changes in individual fields of treatment must be taken into account. A table with a portable base will make it possible to react to such changes. However, it is worth making sure that the system is not equipped with large-diameter wheels – they limit the room for manoeuvre offered by the X-ray C-arm. The profile of the base is also important, it should allow the surgeon to get close to the countertop.
Range of table movement
The ability to set individual table parameters is essential for medical staff but comes at a high price. When choosing a medical imaging table, attention should be paid to the possibility of control. Changes in the position of that type of equipment primarily concern the tabletop. It should also be considered whether the table one is interested in allows for horizontal movements of the tabletop (“floating” tabletop – preferably with a joystick that is comfortable and intuitive for the operator). Attention should be paid to the possibility of Trendelenburg and anti-Trendelenburg tilting, as well as lateral tilting. The X-ray C-arm, cooperating with the table, forces the table to be height-adjustable. It is rarely possible to lift a tabletop more than 1200 mm above the floor level. However, it is worth looking for such a solution as the X-ray C-arm will then work better with the table. Finally, let’s also consider a motorised base. With this solution, one needs to make a profit and loss calculation – will this feature be used often enough to pay that much extra for it?
A purchase to consider
A medical imaging table, just like the X-ray C-arm, is an integral piece of equipment for any operating theatre and X-ray laboratory. As can be noticed, choosing the right solution for the facility is a rather complicated procedure which one can go through safely if one knows the appropriate selection criteria. One needs to consider one’s expectations, what medical imaging tables are offered by manufacturers and compare it with one’s budget. It is also worth paying attention to the reputation of the manufacturer of medical equipment and its service offer.
