Philips aims 16-slice CT product at private practice cardiologists

Philips Medical Systems has developed a 16-slice CT scanner designed specifically for private practice cardiologists. The new system, which will be unveiled this week at the Transcatheter Cardiovascular Therapeutics (TCT) conference in Washington, DC, is restricted to the analysis of cardiac and peripheral vasculature and cannot be used to perform radiologic exams.

"We hope that cardiologists will prefer to buy this system rather than buying a fully featured CT," said Phil Prather, director of global cardiology CT at Philips. "With this, they can continue doing what they traditionally do, but they will do it using a different modality. This preserves the clinical practice of traditional CT for radiologists."

The system, called the Brilliance CT Private Practice CV, is configured for the noninvasive assessment of heart disease. The goal behind its development is to reduce cardiologists' reliance on expensive tests such as cardiac catheterization. The product, which will begin shipping before the end of this year, is priced at $675,000, low enough to fit the budget of private practice cardiologists, according to Prather.

"We have priced this system so it is very attractive for cardiologists to buy instead of a fully featured CT system," he said.

Philips is claiming that the Brilliance CT Private Practice CV promotes faster decision making and, consequently, increased patient volume. In the end, increased efficiency will translate into better care for the patient, Prather said.

Philips is presenting this new system as the best of both worlds-a happy medium that satisfies cardiologists without endangering radiologists' turf.

"By introducing just a cardiac and vascular imaging system, we limit the amount of referral shift from radiologists to cardiologists," he said. "So this is a way of preserving the vast majority of radiology's procedure volumes."

Prather noted that the Brilliance CT Private Practice CV is not the first dedicated cardiac CT product. Siemens, GE, and Toshiba have each built and marketed 16-slice CT scanners optimized for cardiologic applications. Their approach, however, is different from Philips'.

"They basically threw everything into their CT scanners but the kitchen sink and called them cardiac systems. There was no added value," he said. "Our scanner has been developed, constructed, and software-optimized specifically for cardiac and vascular only."

The company's FDA clearance specifically notes indications for cardiac anatomy and peripheral vascular imaging. Prather hopes the Brilliance CT Private Practice CV will do for CT what echocardiography systems have done for ultrasound.

Premium performance ultrasound systems typically are sold to radiologists who perform a variety of tests, most of which do not involve the heart or coronaries. Echocardiography systems are specifically designed around the needs and capabilities of cardiologists.

The Brilliance CT Private Practice CV is designed to do the same in CT. Prather expects most buyers of Philips' new CT to be cardiologists, but he said radiologists might buy it too.

"We can't preclude it being sold to radiologists," he said. "If radiologists want to make this their dedicated cardiac and vascular system, they can do it."

Prather makes no bones about the fact that Philips is going after cardiologists. The company has a strong presence in cardiology and in cardiac imaging, he said. And it was this customer base that came up with the idea.

"We heard cardiologists saying we should figure out a way to produce a system for them-a system that does just the heart and vasculature," he said. "What they were looking for was a system that is clinically prudent, something that gives them clinical and diagnostic results without going over the top."

Philips is the first company to take such a specific, low-cost approach to CT design, but it might not be the last.

"We hope this drives our competitors to introduce similar types of systems," Prather said.

Cardiologists at hospitals or medical centers may be more interested in the new breed of CT scanners being readied for market-the 64- and 40-slice scanners-that will debut commercially at the coming RSNA meeting. But these systems are likely to appeal mostly to radiologists. The market for premium CTs just for cardiologic applications is moving slowly, Prather said.

"We are not seeing as vibrant an uptake of CT technology in the hospital segment (for cardiology applications) as we are in private practice," he said. "We felt the dedicated 16-slice system was the right product at the right time."

To boost the sales of this scanner, Philips has developed business management services. These include financial assistance, help in billing and coding procedures for reimbursement by third-party payers, and marketing implementation assistance.

Sixteen slices provides all the power a cardiologist in private practice will need to break into the cardiac CT marketplace, according to Prather. Pilot data from a multicenter study, called the coronary assessment by computed tomographic scanning and catheter angiography (CATSCAN), indicate that 16-slice CT has a better than 99% negative predictive value, observing all segments of a 15-segment ACC (American College of Cardiology) coronary tree.

"The main capability of CT as a diagnostic tool in cardiology is in coronary rule out," he said. "In Q1 next year, we will have formal publication of the CATSCAN results, and with that there will be a large acceptance in the community of at least a Philips 16-slice capability for cardiac."

Sixteen-slice CT provides a fast, consistent means for determining which of several routes-medication, cath lab diagnostics, or surgery-is most appropriate, Prather said. It is not necessary, therefore, to equip a CT scanner dedicated to cardiac with more than 16 slices, at least not yet.

Philips plans to offer by July next year a 64-slice upgrade to purchasers of the Brilliance CT Private Practice CV. Company strategists have not yet decided whether the product will be restricted to cardiologic applications.

"Assuming that this system is well accepted, then the upgrade will be a dedicated cardiac and vascular system," Prather said.