Mobile P.E.T. unveils first traveling cardiac unit; service route begins in April in the L.A. area

Mobile P.E.T. Systems of San Diego unveiled the first mobile cardiac positron emission tomography unit March 12 at the American College of Cardiology meeting in Anaheim, CA, and is starting its first service route in April in the Los Angeles area.

The coach-borne PET system is a Posicam HZ unit manufactured by Positron Corp. of Houston. It uses a Bracco strontium/rubidium 82 generator and infusion system, which allows Rb-82 to be generated from strontium 82 in a unit on the trailer and automatically administered intravenously to the patient. Rb-82 has a half-life of only 75 seconds.

PET technology uses radioactively labeled compounds that allow imaging and measuring of biological processes that may indicate disease (distinguishing it from CT and MR, which examine structural changes). Cardiac PET procedures are also gaining wider acceptance because they can cut the cost of managing coronary artery disease by reducing the number of unnecessary angiograms and bypass operations.

GE Medical Systems introduced its first mobile PET camera at last November’s Radiological Society of North America show, and sold its first unit to San Diego, CA-based Mobile P.E.T. Systems (SCAN 3/1/00), which plans to outfit the coach and send it on the road in Texas in April. The company also has a dedicated GE system installed at its London PET center. Both are oncology units.

Sparked by its successful debut of mobile PET services at the October 1999 European Association of Nuclear Medicine meeting in Barcelona, Spain, Mobile P.E.T. will be the first company to provide mobile PET service in Europe when the mobile Siemens/CTI ECAT Exact PET imaging camera (SCAN 11/10/99) goes into the field in late April in Germany.

Mobile P.E.T. Systems owns and soon will be operating five units, four of them in the U.S. European service will be through Mobile P.E.T. Systems Europe, a joint venture with Neuromed of Germany, according to spokesperson Jill Janik.

Plans for this year are to put approximately 20 mobile units into operation in the U.S. and four in Europe, primarily for oncology services. In cardiology, the company hopes to operate four to six routes by the end of the year.

Company on fast trackMobile P.E.T. was founded in November 1998 and went public the following month, bolstered by favorable reimbursement status for PET from Medicare and some private insurance companies, according to Mobile P.E.T. Systems president and CEO Paul J. Crowe. Mobile P.E.T. got a $13 million cash infusion this March from an institutional investor. The company now has about 40 employees and did between 600 and 800 patient procedures in the second half of 1999 in the Los Angeles and New York areas, Crowe said.

“The whole idea was to provide a new platform for access to this technology for doctors and hospitals. It’s modeled after similar mobile businesses,” Crowe said.

Hospitals can contract for a full or half day, bundle their patients, and have access to PET as they need it.

“That way, hospitals can build patient flows and eventually justify a dedicated unit,” he said.

Crowe said Mobile P.E.T. is often approached by physicians and hospital administrators interested in dedicated PET facilities. Once everyone buys into the PET concept, the company brings in one of its mobile units to start building patient referrals and volumes during development and construction of the dedicated center. He said a facility needs approximately four patients a day to break even with either a dedicated or a mobile system.

The Positron mobile scanner was designed specifically for cardiac PET, Crowe said. All PET systems have cardiac capability, but this particular device has features and some software that make it more applicable for cardiovascular studies, he said.

“Positron made its name in cardiology circles. Positron has had more exposure in cardiology, and we felt it was the appropriate technology to use to introduce cardiac PET. They have software that was designed over the years by cardiologists. The 16 centers in the United States that are dedicated cardiac facilities are all Positron,” Crowe said.

Positron reboundsThe alliance with Mobile P.E.T. is quite a success story for Positron, which in 1996 was poised to purchase GE Medical Systems’ PET products rights, then virtually disappeared off the map.

The company was started in 1983, but PET during that early period was mainly used in research and was not reimbursable. Positron had a tough time, despite its technology, according to John Ariatti, vice president for sales and marketing.

“Financially, it wasn’t making it. The company was in the financial doldrums,” Ariatti said.

From the collapse of the GE contract in 1996 until 1998, Positron concentrated on supporting its customer base and holding onto key technical people and patents while it looked for financial help.

“What happened with the GE deal,” said Positron president Gary H. Brooks, “was that GE had agreed to sell the rights to their (PET) technology to Positron, which was having trouble raising the money they needed. At the same time, GE was having trouble fulfilling their obligations for orders. They had indicated to Positron there was a certain level of orders and they (GE) couldn’t (fill) them.

“The deal basically collapsed. Positron (got) the money ready, but GE didn’t have the orders, and without the orders, the financing behind Positron collapsed. Nobody would support the GE technology purchase unless there were orders to back it. GE failed to fulfill that,” Brooks said.

In the summer of 1999, Positron received an infusion of equity funding, which Imatron helped them find. Imatron then reconfigured the management of Positron, making Brooks president, and restarted the company, Ariatti said.

“How did Positron come back? If you trace it back to late in 1997,” Brooks said, “Imatron Japan approached Imatron and said they needed a PET scanner in Japan. There aren’t very many PET scanners, and they were looking at this little tiny company in Houston called Positron. They said they wanted us to go down there and check it out. That’s what Imatron did.”

Brooks was CFO of Imatron at the time.

Imatron went back to the Japanese and told them it was a tough proposition. All Positron was doing was maintaining its field service. The Japanese told Imatron they had a 10-unit order if Positron could be brought back.

“We got the Imatron board to bridge-loan Positron $600,000 that kept the company alive. During that time we got together with two groups and raised 90% of the (necessary) money, about $12.5 million,” Brooks said.

There is no ongoing backing from Imatron, which bought half the company for $100 and refinanced it, diluting Imatron’s position. Imatron now owns about 16% of Positron.

Imatron owned 54% of Positron at one time, Brooks said.

“We (Imatron) controlled Positron for a brief period. Imatron doesn’t want to run Positron long distance. They have 9 million shares of Positron, so if Positron does well, they’ll do very, very well as a result,” he said.

Although Positron’s product was good, its company management wasn’t. Sales were small and there was no reimbursement—they ran out of money, Brooks said.

Imatron specializes in electron beam tomography to detect coronary calcium scoring, an indicator of future heart attack. The company’s goal in working with Positron, Ariatti and Brooks said, is to merge technologies, utilizing PET to view myocardial perfusion.

“We’re working at being able to superimpose three-dimensional images from EBT studies along with PET studies,” Brooks said. “From a disease-management standpoint, they certainly do lock in together.”

Positron’s main scanning platform has been the Posicam, which will be succeeded this summer by the mPower, which has more advanced hardware and software.