In an industry muddled by clever wording and hidden meanings, the announcement at the 2006 RSNA meeting that Philips Medical Systems had developed an MR system that can be upgraded from 1.5T to 3T brought to mind the rumblings of a forklift and weeks of downtime.
In an industry muddled by clever wording and hidden meanings, the announcement at the 2006 RSNA meeting that Philips Medical Systems had developed an MR system that can be upgraded from 1.5T to 3T brought to mind the rumblings of a forklift and weeks of downtime. And for good reason.
Comparatively simple tasks in the past-the upgrade of a quadslice CT to a 16-slice configuration, for example-were accomplished awkwardly, not as vendors had promised, by removing one gantry and putting in another, but by replacing the entire scanner. This practice, known pejoratively as a forklift upgrade, was dubbed a gantry swap by vendors, who eschewed the term trade-in.
This time around, however, Philips executives mean exactly what they say, according to Jacques Coumans, Ph.D., Philips vice president of MR global marketing. The company's Achieva XR actually can be upgraded from 1.5T to 3T onsite, without a forklift. The reason is the magnet itself, a superconductor that can be configured to operate at either field strength.
Achieva XR is designed to run initially at 1.5T in a configuration that costs more than a conventional 1.5T scanner but hundreds of thousands of dollars less than a 3T system. Upgrading later to 3T involves applying more current to ramp the magnet to the higher field strength and swapping the body coil for one compatible with 3T. The gradients do not have to be changed, however, nor does any other hardware.
With Achieva XR, therefore, Philips lays claim to a level of upgradability that may be in perfect tune with the times. Cuts in reimbursements, such as those that took place Jan. 1 under the 2005 Deficit Reduction Act, have given outpatient imaging centers a bad case of the willies when it comes to buying new imaging equipment.
"We want the flexibility to upgrade without racking up too many added expenses," said Steven R. Renard, president and chief operating officer of Liberty Pacific Medical Imaging based in Encino, CA, which owns and operates medical diagnostic imaging centers mostly in California. "The worst possible situation would be to buy new equipment and then find ourselves behind the technology curve."
Achieva XR provides an opportunity to remain at 1.5T at a time when most healthcare providers are providing service at this field strength, while preserving the opportunity to cost-effectively upgrade to 3T at a later date. In the long run, customers who choose to lease Achieva XR may actually do as well as if they leased a conventional 1.5T scanner, thanks to some creative financing by Philips.
"The fair market value of the asset at the end of the lease is significantly higher for Achieva XR than it is for a conventional 1.5T scanner," Coumans said. "Hence, the lease payments can be similar, if not equal (to those for a 1.5T device)."
Upgrading Achieva XR to 3T is more cost-effective than buying a 1.5T system and later replacing it with one at 3T, he said. Philips staff have calculated the cost savings of avoiding such a replacement at between $750,000 and a million dollars. These calculations include the cost of remodeling a facility twice, once for 1.5T and again for 3T, the value lost in the 1.5T system due to its sale into the after market, downtime at the site during the transition to 3T, and the likely need to operate a mobile scanner during the changeover.
"All that amounts to a significantly more expensive proposition than choosing the XR system from the get-go," Coumans said.
A version of the field-upgradable MR has been running in the Philips factory since before the RSNA meeting, but the first clinical unit is scheduled for U.S. installation only this month. Full production of the Achieva XR is slated for the end of the second quarter, according to this company.