Sales of gamma cameras have been flat for so long they have become one of the few certainties in the otherwise unpredictable marketplace of medical imaging. True to form, the two factors in a major predictor of future change, equipment orders versus sales, were virtually equal for gamma cameras in the first half of 2004 at about $185 million for North American customers. But there is reason to believe that will change and that the progenitor of this change will be SPECT/CT.

Despite significant increases in data volume, simultaneous implementation of a PACS allowed radiologists at the Groningen University Hospital in the Netherlands to increase productivity with the implementation of four- and 16-slice scanners.

Thirty-day mortality rates in patients with abdominal aortic aneurysms are reduced by two-thirds when physicians use endovascular repair as opposed to conventional open surgery.

CT-guided transthoracic needle biopsy -- a well-established diagnostic procedure in adults with lung tumors -- can also help children avoid open surgical or thoracoscopic biopsy, according to a study in the September issue of the Journal of Vascular and Interventional Radiology.

GE Healthcare hopes that its flagship LightSpeed VCT will lift the company out of the slice rut into which the CT industry has fallen. The company is positioning the premium scanner as the first true volumetric scanner.

In an industry that has come to define itself by numbers, Siemens Medical Solutions stands alone. According to company executives, it's not the number of CT slices that's important, nor the number of channels carrying data from the detector, and not even the speed at which the CT gantry turns. It's the resolution and robustness of the system and its ability to meet clinical needs within specific budgets.

Strategy and tactics distinguish Philips in CT. Not long ago, the company was a nonplayer in this modality, reliant on suppliers to obtain scanners to sell under the Philips label. That changed in 2002 with the acquisition of Marconi Medical Systems, which transformed Philips into a CT powerhouse. At last year's RSNA meeting, the company leaped beyond the expected 32-slice configuration to offer a 40-slice array rotating at 0.42 second and covering most body organs without motion artifact.

Toshiba's strength in CT is an outgrowth of its development of sensor technologies in key modalities. Efforts in CT have produced a 64-slice detector, which will be showcased at the RSNA meeting as part of a continuum of engineering that already extends to a 256-slice detector prototype. The company will display the prototype as evidence of its technological prowess.