Portable X-ray systems are unlikely to trip-up if current market forecasts hold steady. And standouts among the sector are the wireless offerings manufacturers are starting to tout.

The global X-ray market was valued at $7.05 billion in 2010 and is forecasted to reach $8.65 billion by 2016, according to the MarketsandMarkets report, “X-ray Market (2011-2016) - Competitive Landscape & Global Forecasts to 2016,” due to be published next month. Mobile X-rays – predicted to take an expanding piece of the pie over that time period — have proven indispensable for many facilities.

“They are really workhorses of the facility,” says Helen Titus, Carestream Health’s worldwide marketing manager for digital capture. “They don’t get the number of images per week or per day that a stationary X-ray room would, but they do get a workout because they’re banged around so much as they’re being moved everywhere.”

Analog portable X-ray units tend to last for 10 to 12 years, according to Greg Neukirch, Philips Healthcare’s vice president of North America imaging systems for interventional and diagnostic X-ray. As far as digital portables go, it is unclear what their typical life cycle will be since they are still fairly new to the market.

Neukirch estimates that a new wireless portable unit will cost anywhere from $170,000 to $220,000, depending on the system’s manufacturer and features. The price of analog portables is typically between $35,000 and $40,000, he says.

New portables
At the Radiological Society of North America’s annual meeting in late 2011, Philips Healthcare introduced the second version of its MobileDiagnost wDR, a digital mobile radiography system with a wireless portable detector. Neukirch says it uses the same wireless detector, user interface and image-processing algorithms featured in the DigitalDiagnost, the OEM’s room-based X-ray system. “We could have a user go back and forth without any having to relearn how to use the unit,” he says.

Also at the show, Siemens Healthcare launched a new portable X-ray system called the Mobilett Mira, which received Food and Drug Administration clearance in September. “The name Mira comes from the Spanish word ‘mirar,’ [which means] ‘to look,’ because that’s what you’re doing when you’re doing X-ray — you’re looking for something,” says Herbert Westin, the company’s senior director of marketing for surgery and urology. The Mobilett Mira is also offered in a pediatrics version, which is painted to resemble a giraffe. Siemens has also published a comic book, “The Mighty Marvels of Mobilett Mira,” which illustrates how the system can be used in multiple clinical situations.

Meanwhile, Agfa Healthcare launched the DX-D 100 Wireless, a mobile digital X-ray unit with a wireless detector. Using the manufacturer’s MUSICA² imaging processing software and NX workstation, the DX-D 100 Wireless can be used with several types of general radiography X-ray studies and is said to enhance patient safety, comfort and positioning for bedside mobile imaging.


According to Carestream’s Titus, the company showed off their DRX-Revolution, a work-in-progress mobile X-ray unit powered by the wireless DRX detector. “This is a DR system complete from the ground up,” she says, mentioning that it has a collapsible column, “so when the tech is driving in those tight hallways, they have a clear view, and then when they get to the room, they can extend the column up.” The DRX-Revolution, Carestream’s first portable X-ray system, is pending FDA clearance. The company expects to begin selling the unit by the middle of this year.

GE Healthcare recently released its new line of portable X-ray systems, including the Optima XR220amx, a digital unit that features 15kW and 30kW generator options and uses a wireless digital detector called FlashPad. “It really represents everything about the AMX product line, known for its durability, reliability and user-friendliness,” says Dave Widmann, the OEM’s general manager of Rad/R&F.



Sales in the sector
Due in part to the introduction of the MobileDiagnost wDR, the portable sales for Philips Healthcare have been strong. “We’ve had very strong sales in the first three months of selling the unit this year,” Neukirch reports.

Westin describes the sales for Siemens’ portable units as being “steady,” and Titus says that Carestream’s portable business has been “very good.”

Greg Cefalo, Agfa Healthcare’s U.S. imaging business unit manager, has noticed that the company’s sales for tethered portable units have been slow. “The market really wants the wireless, that message is loud and clear,” he says. “We stopped shipping the tethered units probably in May or June . . . the wireless units are huge.”

“Our portable units have been doing quite well,” says Widmann, on behalf of GE Healthcare. He adds that the company has seen “some very nice growth for the business.”

Trending toward digital and wireless
It seems that the major manufacturers of portable X-ray all agree that the biggest trend in the sector has been the increasing interest in digital technology.

“Everybody wants it because it’s faster, it does lower-dose and it improves the quality of images dramatically,” says Neukirch.

“What we’ve seen is customers wanting not only the flexibility that digital offers, but the durability and reliability of the detector panels so they can have confidence in the availability of the equipment to deliver a digital X-ray,” says Widmann. “I think our customers are also looking to not sacrifice the quality of the image that they see in their digital portable, just because it is portable. They’re asking for the same image quality that they see with a fixed rad room.”

Digital and motorized portables more prevalent in U.S.
According to Westin, digital portable X-ray systems are not as common internationally. “In a lot of other parts of the world, they are looking more for a basic portable X-ray system,” he says. “If you look into the developing countries, they are interested in doing X-ray with a portable system, but they don’t insist that it be digital.”

“I believe the U.S. sector is the hottest for portable digital right now,” says Cefalo. “I think other sectors will catch on, but the U.S. is really hot.”

Widmann has noticed that motorized mobile systems are more popular in the U.S. than they are in the majority of other countries, which seem to prefer non-motorized portable units. “We sell a good number of non-motorized systems abroad that we don’t see much of in the USA,” he says.

Upgrades for analog technology
Unlike with fluoroscopy, dose reduction is not a driving factor for portable X-ray sales, experts say. But, updates are being made in other areas to pique buyer interest. Some companies offer digital upgrade kits to transform portable X-ray machines from analog to digital. This can help those facilities unable to afford a new digital unit.

Over a year ago, Carestream Health introduced the DRX-Mobile Retrofit Kit for GE, Siemens and Shimadzu analog systems. “Now we have a model called the DRX-Transportable, and that retrofit kit goes on basically any manufacturer,” says Titus.

According to Widmann, GE Healthcare offers FlashPad upgrades to some of their fluoroscopy and Proteus lines of equipment.

Prior to purchase
There are several factors customers should take into account before they commit to buying a portable X-ray system. For starters, they should consider the user interface, which helps to determine how easily technologists can transition from fixed to portable systems. The detector, ease-of-use and power of the unit are other attributes customers should look out for.

“What you want to accomplish is to improve your workflow and have superior image quality,” says Westin. “In cases of intensive care and emergencies, you need to get good diagnostic images.”

“You want to be able to have flexibility in how you use it, when you use it,” says Cefalo. “You want to be able to turn it in tight spaces because they’re heavy—you can’t lift it, they just weigh too much . . . you want a really flexible positioning capability.”

Durability is another essential quality that customers should look for in a mobile system. “Portables sometimes have a life that transcends the normal use factors,” says Widmann. “I would never say that they get run into walls on purpose, but let’s just say that they’re designed to be used in a different fashion, and so they have to be reliable. You certainly don’t want your portable unit to break.”

Widmann also mentions that customers should seek out an integrated portable unit that can take images right away in different types of situations. “The portable detector [should be] in sync with the generator and the tube operation of the unit so that you’ve got consistency and don’t need to worry about either waiting for an X-ray to arrive or some complication between the operation of the digital panel and the X-ray unit itself,” he says.

Struggles in the sector
“I think that the biggest challenge is price,” says Neukirch.

Another struggle for vendors is being able to rise above the competition. How can a company successfully compete in today’s portable market? “If you offer a good product and provide good support and fulfill the requirements for ease of use and workflow improvements, you’re in a good position,” says Westin.

Infection control is another challenge faced by the portable sector. “You’ve got this machine going from patient to patient to patient, room to room to room, so you want to make sure it’s designed to [prevent contamination] and/or the areas that contact patients can be cleaned easily,” says Cefalo.

Goodbye, analog
The general consensus among industry experts is that digital portable X-ray systems will eventually become the norm. The sector will also see more options moving forward.

“I think to make it more useful for not only the radiologist but also the technologist and ultimately the patient in terms of speed of imaging, you’ll see a continued development around detector technology offering more capabilities and advanced applications so you can see more with the image,” says Widmann. “The portable units themselves will continue to play an important role in terms of durability and reliability, especially as customers begin to live with digital panels on a longer-term basis, and the pace of innovation on digital panels begins to change.”

“Portable X-ray will always be needed, it will not go away,” says Westin. “It’s going to [become] completely digital—there will not be any analog systems anymore. However, the transition is going to take many years.”

DOTmed Registered Portable X-ray 2011 Companies

Names in boldface are Premium Listings.
Domestic
Doug Anderson, DGA Medical,LLC, AZ
David Denholtz, Integrity Medical Systems, Inc., FL
DOTmed Certified
DOTmed 100
Eric Smith, SOS Medical Imaging, NC
DOTmed Certified
DOTmed 100
Sal Aidone, Deccaid Services Inc., NY
DOTmed Certified

International
Mads Vittrup, AGITO Medical, Denmark
DOTmed 100
Ramon Estrada Espinosa, Tecnico Sistemas Medicos, S.A. de C.V. (TESIMESA), Mexico