The most obvious disadvantage of DR technology is its price. There were high hopes when the technology first emerged, but the economy has been stunting growth in more recent years.

"The projections were that they would far outsell CR at this point, but that has just not been the case," says Penny Maier, director of marketing for Imaging Systems at Fujifilm Medical, a leader in CR for many years. "CR is probably still three to one over sales of DR, but that number is catching up more quickly as the price comes down."

Many see the hospital market as being CR-saturated, with most new hospital sales attributed to replacement or expansion of their current technology.

"The way the market is going with CR, we see a lot more being placed into the non-hospital segment - the smaller facilities, the private practices, the imaging centers and clinics," says Heizyk.

What are the disadvantages of CR? Imaging speed can be anywhere from 30 to 50 percent faster with direct-capture methods, and you cut out the middleman, but hospitals that have a lot of different X-ray sites and are less centralized may find that CR works better.

Another possible disadvantage of DR is the high cost after the first five years or so. For Medrad, a Pennsylvania-based medical supply and service company which deals with Carestream, Agfa and Fuji systems, offering service for DR units may be on the horizon, but for now it's all about CR.

"Medrad is focusing on film processors in CR," says Nick Hersman, associate product manager for Medrad. "We're noticing in the market a slow transition from CR to DR because of some of the higher capital investments required to transition."

It's all digital

Let's not get confused. When we talk about CR and DR, it is important to remember that we aren't talking about a completely different modality. The two are more alike than dissimilar.

"CR is a form of digital technology," says Werner, marketing manager for Digital Products at Konica Minolta. Werner explained that the term "DR" is something of a misnomer, because while CR technology is essentially cassette-based and read by a laser scanner and DR uses direct-capture technology with fixed or wireless flat panel technologies, but technically, both are digital.

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