Luminaries play key role in identifying applications

Two years after its debut, multislice SPECT/CT offers a market snapshot showing gradual progress in oncology, infection, and cardiovascular imaging. Work under way by early adopters shows potential, but the market appears to be taking a cautious approach to the latest generation of hybrid technology.

Since launching its MSCT hybrids, Siemens Medical Solutions has installed about 50 units worldwide, and Philips Medical Systems has placed about 10.

GE Healthcare, which launched the first SPECT/CT unit seven years ago and today claims a worldwide installed base of about 600, has taken a different tack. Its product is a high-performance gamma camera linked to a low-resolution single-slice CT, which competitors describe as "nondiagnostic." GE execs acknowledge that the company's CT is not designed to deliver diagnostic-quality images. Rather, the CT is built for attenuation correction and localization.

In June, the company plans a commercial launch of an updated version of the Hawkeye that incorporates a quadslice CT priced under $500,000. Siemens' and Philips' systems, both of which boast diagnostic CT, range in price from $500,000 to well over $1 million. The companies are hoping for a market surge based on research in progress involving hybrids that incorporate MSCTs with submillimeter resolution.

Multislice SPECT/CT might be very helpful in precisely localizing infection or tracking down the exact location of joint pain. Both applications are under investigation at Philips' luminary sites.

Siemens is exploring similar applications. To date, the company has sold its TruePoint Symbia SPECT/CTs into hospital nuclear medicine and radiology departments, as well as outpatient clinics, mostly for oncology applications and infection scanning, although cardiology is another major applications area. Some customers use the hybrids for half the day and the CT component for the remainder, said Markus B. Lusser, vice president of global marketing and sales for Siemens molecular imaging.

GE contends that price is a limiting factor, while Philips and Siemens counter that multislice configurations will define future applications. Both arguments may be moot if the price of CT technology continues to drop. As each vendor adds more slices, dual-, quad-, six-, and even 16-slice platforms may decrease dramatically in price and bring diagnostic-quality SPECT/CT systems under the $500,000 ceiling.

Philips and Siemens both have opted for relatively low-power solutions in their SPECT/CT systems.

Philips offers a six- and a 16-slice configuration of its Precedence platform. Siemens offers three versions of its TruePoint hybrid, featuring single-, dual-, and six-slice CTs.

Neither company plans to expand its portfolio to the upper regions of performance found in PET/CT, which is replete with 64-slice scanners from each of the major vendors. Instead, marketing efforts have been aimed at winning acceptance of multislice SPECT/CTs as a staple of the nuclear medicine community.

Lusser says interest in Siemens' SPECT/CT began picking up last fall. He believes that SPECT/CTs will ultimately make up 30% to 40% of the U.S. nuclear medicine market, although this could take three to five years.