MEDICAL DEVICES PHARMACEUTICALS CHEMICALS FOOD & BEVERAGE ELECTRONICS Emerging Applications and Trends Across Medical Imaging VPG Publications, Consulting, Clients www.vpgcorp.com VPG Market Research Reports www.vpgmarketresearch.com VPG Partner Reports www.research-store.com/vpg VENTURE PLANNING GROUP 545 Eighth Avenue, Suite 401 New York, NY 10018 Phone + 1 212 564 2838 Fax + 1 212 564 8133 info@vpgcorp.com
Emerging Applications and Trends Across Medical Imaging Emphasis on the Clinical Impact of Technologies
Table of Contents Executive Summary Research Methodology Magnetic Resonance Imaging Computed Tomography Ultrasound Mammography C-Arms PACS CAD Medical Displays 5 8 12 18 25 34 39 44 49 55 4
Geographic Scope and Segmentation Medical Imaging Modalities Market: Scope and Segmentation (Europe), 2010 GEOGRAPHICAL SCOPE SEGMENTATION Magnetic Resonance Imaging Computed Tomography Ultrasound 2010 MEDICAL IMAGING MODALTIES MARKET Mammography C-Arms PACS This research service examines the global medical imaging modalities market with a greater emphasis on the European region. Medical Displays CAD Key: Segments that are discussed in detail 6
Geographical Overview Industry needs much better emphasis on the 'clinical impact of its technologies This is the only way to influence the market The United Kingdom Scandinavia Benelux and Scandinavia represent two of the most technological advanced countries in terms of imaging IT in Europe and are expected to be the key adopters of enterprise wide image management. Lack of proper reimbursement has always been a challenge in France. Spain Though there is increased adoption of PACS/RIS systems in Spain, declining replacement budgets is worrisome. Benelux France Italy Germany Germany s medical imaging market is the largest of European countries and is predicted to increase. Growing PACS market & greater pressure for efficiency are the main drivers In Italy, there is an increase in the replacement of CR with DR. The popularity of CT and MRI has also increased its budget allocation. 7
Introduction Unparalleled resolution Long scan times Three-dimensional imaging capacity Demerits Artefacts including motion, respiratory, cardiac motion MRI Non-invasive Merits Non-toxic contrast agents Incompatibility with pacemakers, defibrillators, and aneurysm clips Ability to depict soft tissues 13
Market Overview The slowing growth of MRI procedures and competition from other imaging modalities have largely influenced MRI purchasing. Factors such as provider reimbursement cuts and increasingly stringent pre-authorization and pre-certification requirements have played a large role in driving the average annual procedural volume. By 2016, the number of MRI scanners shipped in Europe is expected to reach x,xxx, selling at a weighted average selling price (WASP) of approximately $1.2 million and yielding revenues of $x,xxx.x million. Key Trends With the current challenges in healthcare and economy, as well as some of the technical pitfalls that still exist in 3T imaging, adoption of 3T scanners remains low. However, as industry conditions improve and newly introduced technologies addressing some of the fundamental challenges in 3T imaging prove their effectiveness, 3T imaging is expected to become a standard service in every major facility performing MRI. In order to address the common problem of claustrophobia in patients undergoing MRI exams while maintaining high image quality standards, some manufacturers have recently began introducing x.xt and 3T scanners with xx cm bore diameters. Other manufacturers have brought openconfiguration scanners with high-field ( xt) strength to the market. Outlook MRI Modalities Market Overview Basic Components Representing one of the strongest markets in the medical imaging industry, MRI systems are diagnostic tools that are widely employed by physicians in Europe today. However, there are multiple challenges such as increasing pricing pressures, regulatory issues and competition from CT that need to be overcome in the European MRI modalities market. Despite these challenges, the market is expected to witness growth. The scope for growth is related to the introduction of new applications. Although the western European MRI modalities market is mature, it is not yet saturated, and a few unexplored niche segments offer huge potential. Market Position Main Magnet The following three types of magnets are used in the MRI scanners evaluated in this study: Permanent magnets are made of ferromagnetic materials and used only in very low-field (< x.xt) scanners because of the larger material size and weight requirements needed to produce higher magnetic fields. Superconducting magnets are made of an alloy (typically niobium-titanium) that is cooled by liquid helium to extremely low temperatures in order to lower the resistance to electrical current flow. Gradient magnets are electromagnetic coils powered by electronics that control their magnetic field strength and direction. Radiofrequency (RF) Coils - the role of RF coils includes both the transmission of RF pulses into the patient as well as detection of emitted MRI signals during imaging. Various types of RF coils that fit closely around specific parts of the body are available. A higher signal-to-noise (SNR) ratio and, thus, better image quality can be achieved by using coils that fit closely around the part of the body being imaged. 14
Drivers and Restraints Magnetic Resonance Imaging: Market Drivers and Restraints (Europe), 2011-2015 Wide variety of new MRI applications Replacement driven demand Drivers Restraints Low reimbursement rates Competition from other imaging modalities Quest for systems with a high magnetic strength Demand for refurbished equipment Drivers Restraints Denotes Current Impact Denotes Long Term Impact 15
Emerging Applications and Trends Magnetic Particle Imaging Magnetic Particle Imaging (MPI) has the potential to generate quantitative functional data as well as anatomical images. MPI is similar to PET, has the speed of X-ray and is. one hundred times more sensitive than MRI, but is not quite as sensitive as PET. Briefly, this technology uses the detection of systemically delivered magnetic iron oxide. nanoparticles to capture dynamic images of the cardio-vasculature by monitoring changes within the magnetic field generated directly form the dipole within the nanoparticle. MPI represents a major new functional imaging modality. which can provide rapid, high resolution and quantitative data that can be safely and cost-effectively generated and does not require the production of radioactive material and reduces the need for radiation exposure. PET-MRI The development of an integrated PET-MRI scanner would offer tremendous advantages over single modalities or PET-CT as the PET scan would deliver a modest dose of ionizing radiation whilst the MRI would generate radiation-free, high quality anatomical images. However, the fusion of PET-MRI hardware complicated by the fact that the photomultiplier tubes (PMTs) used to detect and quantify light produced by PET scintillator cannot operate in a magnetic field and the price of developing such an instrument, estimated to be greater than $x million per hybrid PET-CT scanner, may be beyond the scope of most healthcare management programs. Meanwhile companies have already developed the necessary software to fuse PET and MRI images in a process known as image fusion which allows a composite picture to be produced by overlaying images obtained after patients are scanned in separate PET and MRI machines. More recently companies have developed computer aided detection (CAD) algorithms which allow real-time PET imaging to be over-laid with archived reference MRI images to help guide diagnosis, treatment planning and follow-up. 16