The number of nuclear medicine procedures has remained virtually the same since 2007, as providers struggle with lower reimbursements, radioisotope shortages and payer preauthorization regimens, IMV said in a teaser for a new market survey. Doctors are also increasingly lured by other technologies, such as CT and MRI, the Des Plaines, Ill.-based market research firm said.

The IMV 2011 Nuclear Medicine Market Outlook Report is a random selection of more than 430 of the 7,200 U.S. hospitals, imaging centers and private practices that provide SPECT, SPECT-CT and other scans.

This year, the Outlook Report's outlook is fairly bleak. Procedure volume fell about half of 1 percent, from 17.2 million in 2007 to 17 million in 2010, IMV said.
"We attribute this zero growth in procedures to several factors," Lorna Young, senior director of market research with IMV's medical information division, said in a statement.

Young said preauthorization plans from payers and competing technologies for bone density and myocardial perfusion studies likely helped stifle growth.

Also, doctors are worried over the supply of technetium-99m, a radioactive isotope used in nuclear medicine scans whose parent isotope is produced by a handful of aging nuclear reactors around the world. The simultaneous shutdown of two such reactors, one in Canada and one in the Netherlands, led to widespread shortages last year.

However, the top-ranked concern for the future was declining reimbursements from the government and private payers. But the financial squeeze affects private practices more, especially cardiologists, IMV said. In fact, nearly one-third of physician offices polled said they planned to change ownership structure or launch joint ventures with hospitals over the next five years. Similarly, even though one-third of nuclear imaging sites are at doctors' offices now, only one-sixth of purchases will be made by private practices through 2013, IMV said.

Other report findings teased in the release include: dual-head SPECT cameras are the favorite of would-be buyers, making up half of planned purchases (though SPECT-CT will account for one-third of future buys); 87 percent of nuclear medicine procedures performed outside the hospital are cardiovascular studies, compared with fewer than half in the hospital; and the proportion of nuclear medicine sites with outpatient waiting times of more than one day has fallen from 77 percent in 2003 to 43 percent in 2011.

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