Although the advanced volume CT is more complex and can do more than the single slice scanner, the marketplace drivers are similar.

Those planning for the acquisition of a volume CT consider the effects on daily productivity. Reimbursement as dictated by government and private payers plays a major role too. Many of the applications being promoted for these multi-slice CT's are still subject to spotty reimbursement as are all new applications. Competition for available patients is another factor. Not always easy to quantify, available patients based upon the CT's ability to deliver specific applications will play a significant part in determining the value to be delivered by a $1 million plus purchase price.


Technically inclined radiologists often drive such decisions so the savvy hospital or imaging center administrator needs to understand the market for any new device as well as how much capability needs to be purchased to attract the available patient base.

Another influential market factor behind new CT multi-slice technology is the promise of new applications. As those using this new imaging technology publish new and innovative applications the demand grows. Some say reimbursement is what grows a technology, but without the applications driving the demand for reimbursement, growth in the installed base would be limited. Although you can make the argument that once a new medical device reaches a critical mass resulting in local competition, new limited applications and techniques are implemented to further justify the cost of acquisition.

The View from the Supply Side

What of the vendors of the multi-slice or volume CT, how have they responded to this market?

Their goals for the CT were well established: isotropic resolution (similar resolution in all three planes), increased imaging speed (rotate the gantry faster), shorten scan time (increase applications and improve throughput) and sub millimeter resolution (improve lesion detection).

In 2003-4 we saw the introduction of the first multi-slice CT's. First there were 2 then 4 and 8-slice scanners. By doubling numbers of rows, 16-slices was the next expected with 32 close behind. But something happened. Instead of the doubling effect continuing, there was a technology shift and it jumped from 16 to 40 and then 64. The 256-slice CT was forecasted on the day that the 64 began to be marketed.

With the introduction of the larger or volume CT detector certain attributes of the CT scanner had to be changed to meet the objectives set by the manufactures for improved performance.

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