Lunar enters niche MRI with Esaote agreement

Any vendor--particularly a small one--hoping to break into theMRI market during these depressed times needs to find a more cost-effectiveMR mousetrap and a secure niche in which to sell it. Bone densitometrysupplier Lunar will use a North American MRI distribution agreementwith Esaote Biomedica of Italy to plumb the potential of low-costniche MR in a reformed U.S. health-care system.

Lunar took advantage of a change in U.S. marketing organizationsfollowing the formation earlier this year of an MRI joint venturebetween Picker International and Instrumentarium to fill two topslots in its new MRI division:

• Michael A. Silver, formerly MRI director for InstrumentariumImaging, will head up the sales and service effort as directorof Lunar's MRI division. Silver served briefly this year withPicker as director of the magnetic source imaging business obtainedthrough the Instrumentarium joint venture. Silver has worked inthe MRI field for 12 years, with experience at both Philips andDiasonics.

• William A. Conn, marketing manager for Lunar's MRIdivision, was MR marketing manager for Instrumentarium beforemoving to Picker this year as a low-field MRI marketing specialist.Prior to joining Instrumentarium, Conn spent eight years at Philips,eventually becoming high-field product manager.

Esaote introduced its 0.2-tesla permanent magnet Artoscan extremityscanner a year ago, displaying the desk-sized unit for the firsttime in the U.S. at the Radiological Society of North Americameeting last November (SCAN 10/7/92). Lunar, which entered intoan exclusive North American distribution agreement for Artoscanlast month, will show the niche system at this year's RSNA exhibition,according to Silver.

It is not clear, however, whether the system will be displayedas a works-in-progress or commercial product at the November show.Esaote applied to the Food and Drug Administration about eightmonths ago for 510(k) market clearance of Artoscan. Lunar willbegin building its own dedicated MRI sales and service force onceFDA clearance is in hand, Silver said.

While opportunities exist for Lunar to link MRI sales to osteoporosis-relatedapplications of its bone densitometry systems, the firm plansto target radiologists and other general imaging users first witha cost-containment pitch that should sell well in today's managed-health-careenvironment, he told SCAN.

"About 20% to 30% of the MR scans done in the U.S. areextremity-related," Silver said. "This is a system gearedto doing that 20% more cost-effectively in a comfortable environment."

With an anticipated sales price below $400,000 and minimalsiting costs, Artoscan offers an inexpensive way for hospitalsto provide extremity imaging while leaving whole-body systemsopen for other procedures, he said.

"A site can look at paying for the system with one patienta day or less," Silver said.

Niche MRI systems will allow users to function in limited applicationswithin rapidly declining U.S. reimbursement levels, he said. Artoscanruns at a cost level that allows profitable operation at reimbursementof $300 or less per procedure, he said.

Artoscan requires no RF shielding or air conditioning and usesstandard 110-volt power. The unit weighs 1600 pounds and can fitinto an area of less than 130 square feet.

The scanner uses standard pulse sequences, such as spin echo,gradient echo and inversion recovery, tuned for joint and extremityscans. Scan time ranges from four to eight minutes. Arms and legsare inserted into the small-bore magnet while the patient sitsin a chair, considerably increasing patient comfort over whole-bodyMRI, Silver said.

Artoscan offers users an alternative path to expanding patientload that can be less expensive than some whole-body upgrades,Conn said. High-field vendors offer upgrades, such as echo-planarimaging, that can cost an additional $600,000.

"We are seeing a lot of the higher field systems goingto those (upgrade) levels, trying to push through the extra twoto three patients per day--and paying a big debt for it,"he said.

While economics will continue to be the predominant justificationfor purchases of limited-application niche scanners, Lunar alsohopes to stimulate MRI clinical research, which may expand orthopedicuse of the modality--and the utility of Artoscan.

"We are in the process of establishing some research programsthat will explore the application of MR into bone research areas,"Silver said. "Looking at bone information has not been ahigh priority in MR imaging. We would like to expand the use ofMR in looking at bone dynamics and bone pathologies."