From the June 2015 issue of HealthCare Business News magazine
My career began over forty years ago. I started in a laboratory as a nuclear chemist, and early on I was introduced to diagnostic imaging, and to me, nuclear medicine was the most interesting of all of the modalities.
When I look at how diagnostic imaging has evolved, I see radiology moving from X-ray machines to CT, to more X-rays, then to MRI, and more anatomical imaging; and over the years the stakeholders have worked very hard to introduce more of the same types of machines by making them bigger and faster. Now I don’t wish to take anything away from radiology, because the advances in image quality from X-ray to MRI are remarkable, yet it’s still just anatomy.
Nuclear medicine on the other hand went from the rectilinear scanner to Anger Logic Gamma Cameras in the 1970s; they next moved to SPECT, then PET and now PET/CT, SPECT/CT and PET/MRI. All the time the advancements were focused on the human condition and the function/physiology of the body when in a diseased state.
These advances didn’t just involve bigger and faster machines, as in radiology. No, they were about advancing our understanding of the body’s physiological response to disease and therapy. Yet for some reason nuclear medicine, which, for all of the advances in imaging, should have grown in importance and diagnostic imaging market share, has not. No matter how many breakthroughs are made nuclear medicine plods along as if it is a very mature specialty, with just 2-3% annual growth. Why is this?
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Some will say the reason is the technology is too complex. Some claim the images, nonanatomical, are too difficult to read. Others will be convinced nuclear medicine is this strange mix of engineering, medicine, technology, physics, chemistry, pharmacy and short half-lived isotopes that makes it attractive to more scientifically oriented people. They’ll claim all of these reasons limit our ability to use nuclear medicine more broadly. I think this is a piece of the puzzle, but only a small one.
The provision of health care is complex, yet somehow we make it happen. As a business development professional I believe the reason behind the steady yet very slow growth of nuclear medicine is something more obvious. I see many different approaches to the marketplace. Companies or institutions offering products or services can take a market leading strategy and blaze new trails. Or a company may choose to be the next wave in, on the newly created trails. The next wave company is always poised to take advantage of every investment the trailblazing company makes in order to increase their market share and importance.