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Special report: Will molecular imaging deliver on its promises?

by Carol Ko, Staff Writer | June 14, 2013
International Day of Radiology 2012
From the June 2013 issue of HealthCare Business News magazine

For instance, researchers are discussing developing innovative CZT-based SPECT detectors. CZT detectors offer several benefits over standard scintillator-based detectors, including much higher energy resolution, which enhances the sensitivity of the camera and improves image quality. CZT detectors are also more compact, potentially leading to better integration in SPECT/CT systems. High costs of production limit wider distribution of such SPECT systems, however.

Though many speculate that PET/CT is going to win out over SPECT in the end, PET radiopharmaceuticals still face a bottleneck for FDA approval. “To fully replace things by PET/CT you need to drive down the costs and get regulatory/ reimbursement issues resolved,” says Stanford University’s Iagaru.

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Nicki Hilliard

Others agree. “I don’t think it will be obsolete. It’s not as glamorous as new modalities but it’s one of the most cost-effective imaging modalities you can do and it demonstrates physiology, not just anatomy,” says Nicki Hilliard, professor of nuclear pharmacy and pharmacy practice at University of Arkansas.

On the horizon
Though it’s difficult to predict what the future holds for molecular imaging in light of the uncertainty around reimbursement, experts cite a few big trends and open questions that will continue to shape the field.

“Hybrid imaging is here to stay and will probably move on to trimodal type imaging devices,” says Siemens’ Brait. Manufacturers such as Siemens and Carestream offer PET/SPECT/CT systems for preclinical small animal imaging, while researchers in Europe are exploring PET/CT/MR’s clinical advantages in imaging lymphoma, myeloma, melanoma, neuroendocrine tumors, and head and neck cancers. While these systems are nowhere near ready for the market, the general consensus is that such systems represent the wave of the future for nuclear medicine.

Professionals also call for streamlining the costly, labyrinthine hurdles of the U.S. FDA regulatory process, which they allege stifles innovation. “Say you have something very good and it’s approved elsewhere. If you need to run the same tests in the U.S., how do you do it in a manner that’s not prohibitive from a cost perspective and in a way where the company will recover those investments?” says Iagaru.

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