"There are relatively few CT systems out there compared to other technologies, like cars," Launders said. "Manufacturers can more easily keep track of all their scanners."

Dose reduction

One new feature potentially pumping up costs is a radiation dose reduction technology called iterative reconstruction. This uses algorithms run on super-powerful computers to scrub away noise from CT images so doctors can take the same scans at much lower doses. All four major CT vendors included in ECRI's research have their own versions. GE Healthcare has VEO and ASIR; Philips Medical Systems has iDose4; Siemens Healthcare has SAFIRE and IRIS; and Toshiba Medical Systems has AIDR3D.

According to manufacturer-run studies, these technologies can help cut the dose for some scans between 50 and 80 percent. For now, they're generally only available on higher-end premium systems, although ECRI does note that some vendors are starting to offer them as optional upgrades for some lower-slice systems, even 16-slice ones.

One reason they're more commonly found on higher-end systems is cost, ECRI said. When bought with the system, IR products can raise the price tag by upwards of $200,000. "The higher-end systems generally run higher volumes so they can assume you'll make back part of the costs," Launders notes. Vendors don't have much wiggle room though, as the high cost largely stems from the big, blisteringly fast computers needed to run the programs.

"The computer power they're now putting in CT scanners used to be the reserve of NASA, it's pretty amazing," Launders said.

However, two third-party companies have started offering cheaper iterative reconstruction technologies, typically going for half or a quarter of the manufacturer's price. One company, Israel's Medic Vision, got its system SafeCT cleared by the Food and Drug Administration only a little over a year ago. And Swedish firm Sapheneia's Clarity was released in 2007.

"The advantage of those is you can link any number of CT scanners, new CT scanners, into their software and produce similar results," Launders said.

Still, even if it's costly, the technology is gradually trickling down to lower-end systems, and doctors are starting to demand it more and more.

"It's now becoming an expectation rather than a nice-to-have luxury. That's definitely changing," Launders said.

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