In addition to the market for imaging equipment used in nuclear medicine, highly specialized technologies are required in the radiopharmacies that produce the isotopes, and in the "hot labs" in hospitals and imaging centers that handle the radioactive tracers. (See related story.)

"The market for straight nuclear medicine hot labs products is down because the PET market is down due to the DRA," confirms Gary Reich, President, Reich Consulting Services, Inc., Plantation, FL. The company builds hot labs that include shielding, casework, and calibration equipment for the safe handling of isotopes. He remains very positive about the future, however. "I am very optimistic because these diagnostic tests are very good. There are always going to be payment problems and challenges. But the fact is this technology is excellent. It helps take care of patients.And I see continued growth. There are always setbacks but long term it's a great industry."


Smaller OEMs also support the nuclear medicine lab markets. An example is Biodex Medical Systems Inc., Shirley, NY, makers of supplies and accessories, such as dose calibrators, thyroid uptake systems, and syringe shieldings. "Our products are driven by new developments, by what the big guys do," says Robert Ranieri, Vice President of Sales. "When PET came on the scene, we developed a whole new line of products to be used with PET isotopes. What really drives the PET business is the scanner sales. You don't need a hot lab unless you are buying a scanner. We have seen that marketplace kind of flat recently."

The promise of future applications and the potential of a "magic bullet" for cancer coming out of nuclear medicine is on the distant horizon and not a factor yet. "It takes a while. There are a lot of promising things out there but in order for it to affect us, it has to become a reality," Ranieri says of the therapeutic outlook.

Approvals of radiopharmaceuticals by government payors (Medicare) drive the market. Currently, the SNM is working with the FDA and National Cancer Institute on the next generation of radiopharmaceuticals. The human genome and super computing helps in the effort to target receptor sites to unleash the therapeutic potential of nuclear medicine in cancer treatment.

"The change in the future is that from a clinical perspective PET/CT is essential in diagnostic management of cancer. We expect that since clinical oncologists and other clinicians are seeing the results and changes in patient management, the increased utilization is just a matter of time. As the procedures grow, they will lead a recovery in the market," forecasts Siemens' Markus Lusser. The company's PET/MR development is also something to watch for in the future.

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