Rick Stockton, president of Nationwide Imaging Services out of Brick, N.J., says 16-slice systems are in highest demand right now, but there is also interest in 64-slice scanners.

"More customers are buying lower-cost systems or the 16-slice scanners," remarks Stockton.


Kramer agrees that 64-slice scanners are still moving, but not as quickly as 16-slice CT systems. "We have sold some 64, but the sales cycle is very long," he says. "Any hospital approval process is getting more complicated and difficult to get through."




Competition in the used market seems also to be picking up. "There have been a couple new players in the market and people are getting more aggressive, but the steady players are going to continue to dominate," says Kramer.

More focus on hospitals

Since the 2007 Deficit Reduction Act went into effect in 2007, the nation's outpatient imaging centers have seen dramatic reductions in CT reimbursement. Manufacturers like Toshiba previously saw 30 percent of their sales coming from outpatient imaging, whereas now that number has dwindled down to about 10 percent and the majority of the market is centered on hospitals. For some, this means a significantly different rhythm of doing business.

"We do still sell some outpatient imaging, but it's not as major of a focus," says Young. "That actually changes our sales cycle. Outpatient imaging can typically be a six-month sales cycle, because it's very easy to get equipment into a little mini-mall or something like that, versus a hospital can be about 12 to 18 months. You just have to think differently and plan differently. We're talking to people now who probably won't get systems in until the end of 2010, but in a way it's better because you can plan out the right CT for them, which is better for health care."

Lowering the dose

Never before has radiation dose weighed so heavily on the design and engineering of new CT systems, but this has long been a concern for radiologists.

"We as radiologists are always concerned about using radiation with medical testing and we want to make sure it is used appropriately for patients, because we don't have a known threshold of radiation below which we know there's no increased risk of cancer," says Dr. Silverman. "There's a lot of work going into radiation dose. The best way to reduce radiation is with the clinical question of whether or not to do the scan at all. That's always in the forefront of the radiologist's mind."

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