SPECT/CT promises to fuel growth of nuclear medicine market

If not for the advent of PET/CT, the nuclear medicine market would be going nowhere. Gamma cameras have slipped into a very long life cycle. Industry executives estimate that customers are holding onto gamma cameras for eight to 10 years, and for good reason.

The last major change in the marketplace, more than a decade ago, was the transition from single- to dual-head variable-angle cameras. Today, customers seem to be awaiting a similarly good reason to purchase new equipment. SPECT/CT featuring multislice CT might provide that reason.

"I see an immediate growth path for this system," said Peter Luyten, general manager for Philips molecular imaging. "We don't have to wait years for new probes to arrive. There are nuclear medicine applications ready to roll right now."

Oncology, a primary user of nuclear medicine, can benefit immediately from the anatomical landmarking and precision possible with multislice CT, Luyten said. SPECT/CT might also be helpful in studies of infection and lung disease, and the hybrids could boost productivity.

"They will lead us into the era of same-day diagnosis," said Ian Farmer, vice president and general manager of Philips nuclear medicine business. "In one day, you can have both a CT and SPECT exam, and the physician will have all the information needed."

SPECT/CTs also offer flexibility. A busy radiology department might purchase the system as a backup, said Markus B. Lusser, vice president of worldwide sales and marketing for Siemens' nuclear medicine division.

"Hospitals that need a second CT scanner as an overflow scanner and maybe also have some challenges with the patient load on gamma cameras can utilize such a machine to offer both studies in one integrated way," he said.

The coming wave of nuclear medicine agents supports a third reason SPECT/CT might be immediately adopted, at least at academic institutions, where the staff will want to assess these new agents. And as molecular imaging catches on, demand for these systems will grow among clinical practitioners, Philips and Siemens executives agree.

GE Healthcare also believes strongly in the future of SPECT/CT. The company has placed more than 450 of its Infinia Hawkeye SPECT/CT systems since 2000. Unlike the Philips and Siemens scanners, the Hawkeye features a CT optimized for attenuation correction and general localization rather than for diagnosis.

According to Jeffrey Kao, general manager of global PET/nuclear medicine in GE's Functional and CT Imaging division, the product is all the market needs right now. But those needs will change soon, and GE will be ready.

"We have merged nuclear medicine, PET, and CT into one organization because we believe the future of functional imaging is one of hybrids," Kao said. "Eventually, there will be no more stand-alone systems."

This appears to be what is happening in positron imaging, where PET/CTs are becoming more popular than dedicated PET scanners. Together, they have overshadowed the rest of nuclear medicine. Sales of PET and PET/CT scanners in the U.S. last year totaled $400 million, the same as gamma cameras. Not long ago, vendors counted themselves lucky to sell a dozen PET scanners in a year.

Given the shared foundation of hybrid scanning, questions may arise regarding a possible negative effect of SPECT/CT on the sale of PET/CTs. SPECT/CTs will cost at least $1 million less than PET/CTs. Philips and Siemens executives concur, however, that the new scanners will not cut into the purchase of PET/CTs, because the two technologies have substantially different applications.

If they are correct, SPECT/CT could signal a new age for nuclear medicine, marked by rising equipment sales and increasing procedure volume. Many veterans in the industry consider it long overdue.