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Metriflow pioneers trend to market niche MR

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Niche MR may be an emerging market, but it is not a totally newfocus of corporate attention. Metriflow Medical Systems of Milwaukeeobtained Food and Drug Administration approval of its AFM-100blood flow scanner five years ago. The firm is just now

Niche MR may be an emerging market, but it is not a totally newfocus of corporate attention. Metriflow Medical Systems of Milwaukeeobtained Food and Drug Administration approval of its AFM-100blood flow scanner five years ago. The firm is just now acceleratingits commercial push as positive clinical research results comeon board.

"We have spent the last couple of years working with ourusers, demonstrating diagnostic applications and assisting inthe preparation of abstracts and papers for publications,"said chairman William K. Genthe.

Metriflow's scanner sells for $320,000. It is used primarilyby vascular surgeons as well as interventional radiologists andcardiologists. Twelve AFM systems have been installed in the U.S.and one in France, he said.

The magnetic resonance flowmetry (MRF) system does not provideimages, but rather, measures vascular blood flow through a crosssection of a patient's leg. Metriflow is working on a combinedimaging and blood measurement system, however, Genthe told SCAN.

"We have developed a good homogeneous 0.1-tesla permanentmagnet," he said. "Using one of our magnets, we havebuilt a conventional imaging MR system. This is the foundationfor our longer term objective of developing a quantitative magneticresonance angiography system at low field, which combines thequantitative capabilities of the present system with MR angiography."

METRIFLOW IS SEEKING A BUSINESS PARTNER with international strengthto help sell and service its MRF systems. Existing vendors ofmedical imaging equipment able to cooperate in development ofthe new combined MRI/MRF system are prime candidates for partnershipwith the company, he said.

"We would very much like to ally ourselves with (a company)that not only has marketing presence and is well established internationally,but also has a strong technological team and interest in developingniche devices for specific applications," Genthe said.

Metriflow obtained an exclusive worldwide license for the MRFtechnology from the Medical College of Wisconsin at the time thefirm was formed in 1984. It then spent several years translatingthe technology into a commercial product.

After an initial stab at marketing, including display of thescanner at the Radiological Society of North America meeting,Metriflow pulled back to develop the MRF system further and assistin proving clinical utility through the research efforts of itsinitial users.

Along with clinical utility, Metriflow has had to convincepotential users of its system that MRF can reduce overall costsin diagnosing and treating peripheral vascular disease.

"We had to show in case studies that money is saved whenthe scanner is used," Genthe said.

In some cases, cost savings occur by avoiding the need forangiography. MRF can also show when there is insufficient bloodflow to warrant proceeding with wound healing therapy. Its quantitativeflow measurements can also help physicians make choices betweentypes of vascular disease therapies, he said.

"Of the 500,000 diagnostic angiograms done (in the U.S.annually) a significant number of those patients don't go on forintervention. We can cut down the number of angiograms performedon nonsurgical patients," Genthe said.

Research results presented at the Midwest Vascular SurgicalSociety meeting in Cleveland this month by a team from the OchsnerClinic support the company's case that MRF can serve as a noninvasiveway to determine which patients are suitable for surgery priorto the use of angiography.

"MRF could be used successfully to screen patients forrevascularization, reducing the number of nonsurgical candidateswho need angiography," the Ochsner group reported.

While technological developments in ultrasound are closingin on the quantification of blood flow, this modality is restrictedto measurement within a particular vessel. The same is the casefor MRI. Nuclear medicine can also be used to measure flow butrequires the invasive use of radiotracers, Genthe said.

Reimbursement for MRF studies is well established in the U.S.,he said, through a combination of vascular and radiology CPT codes.

"It (the codes used) depends upon the department the scanneris located in and the applications it is being put to," hesaid.

Metriflow's experience spreading MR technology into the peripheralvascular arena may be a sign of increased niche opportunitiesto come, Genthe said.

"Our scanner is a niche device," he said. "Growthin niche MR applications is a logical trend. Many things can bedone well with MR. If they can be done as simply and cheaply (asalternative technologies), the trend will accelerate."

BRIEFLY NOTED:

  • Shipments of U.S.-manufactured x-ray and other irradiationequipment increased by a healthy 13% in 1991, from $1.9 billionto $2.1 billion, according to U.S. census figures (see graph).This equipment category includes nuclear medicine and x-ray devicesbuilt for industrial as well as medical applications. Shipmentsin this category slumped from 1986 through 1988 but have steadilyincreased over the past three years.

  • Du Pont signed a major group purchasing agreement thismonth with American Healthcare Systems Purchasing Partners. SanDiego-based AHSPP is a limited partnership for which the generalpartner is American Healthcare Systems. American Healthcare Systemsis a for-profit corporation with 40 shareholders representingover 1000 nonprofit hospitals in the U.S.

The agreement covers all health-care products from Du Pont,including its medical imaging film and equipment line and radiopharmaceuticalsfrom Du Pont Merck Pharmaceutical. Products from other Du Pontbusinesses will also be included in the supply arrangement.

  • Syncor, the Chatsworth, CA, radiopharmacy company, experienceda sharp 25.9% increase in revenue for its first quarter (end-August),from $47.3 million in the first quarter of fiscal 1992 to $59.6million. Net income rose 39% for the period, from $1.6 millionin 1992 to $2.2 million in this fiscal year.

Much of Syncor's revenue boost can be attributed to increasedsales of Du Pont Merck's Cardiolite cardiac SPECT agent and I.V.Persantine, a pharmacological stresser, the company said. Syncornow operates 95 nuclear pharmacies in the U.S.

"Nuclear medicine will continue recent accelerated growthand change as additional imaging agents receive regulatory approval,"predicted president and CEO Gene R. McGrevin.

  • Mallinckrodt Medical of St. Louis opened two radiopharmacies--inKansas City and Baltimore--last month, increasing its U.S. nuclearpharmacy chain to 29. Three additional pharmacies are expectedto open by year's end, said William J. Mercer, senior vice presidentand group executive.

Mallinckrodt estimated the current annual nuclear medicinepharmaceutical market at $600 million worldwide. The radiopharmaceuticalmanufacturer and distributor projected growth in the global marketat a compound annual rate of 13%, reaching about $1.1 billionby the middle of this decade.

  • Philips Medical Systems has signed on with Citicorp NorthAmerica to provide scanner leasing services. Citicorp is a leadingfinancier to hospitals, according to Philips. The two will offerpackages that combine equipment and maintenance costs into a fixedmonthly payment and allow for ease of scanner upgrades, said WynnBlieberg, director of financial services at PMS.

  • Leading barium producer E-Z-Em broke into the market inthe former Soviet Union last month through the signing of a distributionagreement with Turkmerica of Ashgabat, Turkmenistan. Turkmericawill promote and sell E-Z-Em products to government and otherhealth-care institutions in Turkmenistan, Kazakhstan, Kyrgyzstan,Tadzikistan and Uzbekistan.

"We not only want to open new markets for our variousproducts, but would also like to take advantage of the favorablelabor situation in Turkmenistan," said Andrew Zwarun, E-Z-Emvice president.

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