As the trend toward dose-lowering continues, this may turn around in the used market. Kramer is banking on it with the addition of a brand new dose-lowering system coming out in the near future.

Growth in procedures


Growth in sales may have been a little dreary for most of 2009, but the number of procedures is still on the increase.

"CT procedures in North America continue to grow at about 10% per year," remarks Plante. "This growth comes from all clinical protocols, but especially CT angiography (CTA) exams including cardiac CTA."

In addition to cardiac imaging, other areas of growth include neuro and pediatric imaging. CT is also the most commonly used tool for interventional procedures like biopsies, drainages and tumor ablations.

"Right now at Toshiba we are researching a lot of different things," says Young. "We're researching functional and perfusion imaging - we already have it in the brain, but we're looking at doing it in the heart, which could compete with or help augment nuclear or PET scanning as well as body perfusion to look at tumor imaging. What we're seeing is a need for more automation and tools for dose reduction."

Additional applications for CT should develop as CT becomes more like MRI and nuclear imaging by being able to distinguish important characteristics of tissues.

"One of the applications that hopefully soon will become more mainstream is CT colonography," says Dr. Silverman. "In this procedure, the colon is inflated with gas and the CT scan is obtained in both the supine and prone position and the walls of the colon are examined for polyps or cancers. This tool gives us the opportunity to screen many more patients for colon cancer than can be screened using conventional optical colonoscopy."

What about the most diminutive and vulnerable of patients? Today's scanners and dose-lowering software have made it so that children can be scanned in one second, which all but eliminates the need for sedation, an unsavory affair for both doctors and patients.

"CT continues to play an important role in pediatric imaging, especially in acute situations when fast results are essential," says Plante. "As with all requests for imaging, but especially with pediatrics, careful consideration must be given to the applicability of CT. Other techniques that use no ionizing radiation, such as ultrasound or MR, may in some cases be preferred."

Nano CT?

In the far reaches of research and development is talk of a brand new CT technology that would implement a multitude of "nano" X-ray sources, instead of the conventional one or two X-ray tubes. Siemens is known to be involved in this research, and other manufacturers seem interested, as well, but no one is really talking just yet.

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