Medical Imaging Markets

The purpose of this TriMark Publications report is to describe the specific market segment of the diagnostics market sector called medical imaging. Medical imaging can be categorized into nine main modalities: X-ray, ultrasound, computed tomography (CT), positron emission tomography (PET), single photon emission tomography (SPECT), magnetic resonance imaging (MRI), nuclear medicine (NM), mammography and fluoroscopy. Globally, X-ray is the most frequently used imaging procedure with about 108 million X-ray exams per year. MRI is second with 26 million examinations per year. PET, SPECT, CT and nuclear medicine rank third with 30 million examinations per year. Picture archiving and communication systems (PACS) and contrast agents are the sub-segments in medical imaging market that have gained significant growth in recent years. As a result of these medical imaging advancements, the multi-slice systems are generating large volumes of data, and this creates demand for data storage, 3-D visualization and analysis. As such, the global medical imaging industry is primed to experience significant growth through the next decade. This report surveys almost all of the companies known to be marketing, manufacturing or developing medical imaging equipment and supplies in the world. Each company is discussed in extensive depth with a section on its history, product line, business and marketing analysis, and a subjective commentary of the company's market position. Detailed tables and charts with sales forecasts and market data are also included.
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1. Overview 11
1.1 Statement of Report 11
1.2 Scope of this Report 11
1.3 Methodology 12
1.4 Executive Summary 13
1.4.1 Outlook for Medical Imaging 13
1.4.2 Outlook for Computed Tomography (CT) 13
1.4.3 Outlook for Magnetic Resonance Imaging (MRI) 13
1.4.4 Outlook for Positron Emission Tomography (PET) 14
1.4.5 Outlook for Single-Photon Emission Computed Tomography (SPECT) 14
1.4.6 Outlook for Hybrid Modalities 14
1.4.8 Outlook for Mammography 15
1.4.9 Outlook for Digital Radiography/Computed Radiography (DR/CR) 16
1.4.10 Outlook for Image-Guided Radiation Therapy (IGRT) 16
1.4.11 Outlook for Cardiac CT Imaging 16
1.4.12 Outlook for CT Angiography 17
1.4.13 Outlook for Nuclear Medicine in Cardiac Imaging 17
1.4.14 Outlook for MRI vs. SPECT in Cardiac Procedures 17
1.4.15 Outlook for Echocardiography in Cardiac Imaging 17
1.4.16 Outlook for Optical Coherence Tomography (OCT) 18
1.4.17 Outlook for Health IT 18
1.5 Market Drivers in Medical Imaging 18
1.5.1 Diagnostic Imaging Hardware 18
1.5.2 Miniaturization/Computing power 18
1.5.3 Fusion/Multimodality 18
1.5.4 Diagnostic Imaging Software 19
1.5.5 3D/4D Imaging 19
1.5.6 Computer-Aided Detection (CAD) 19
1.5.7 Workflow Automation 19
1.5.8 Enabling Technologies 19
1.5.9 Digitization 19
1.5.10 Client-Server Technology 20
1.5.11 Interoperability and Standardization 20
1.6 Challenges in Medical Imaging 20
1.6.1 Legal and Regulatory Constraints 20
1.6.1.1 U.S. Healthcare Reform 20
1.6.1.2 Reimbursement 20
1.6.1.3 Intellectual Property Protection for Imaging Software 21
1.6.1.4 OEM Relationships 21
1.6.1.5 Budgetary Concerns 21
1.6.1.6 Equity Funding Constraints 22
1.7.3 Breakeven Analysis for Magnetic Resonance Imaging (MRI) 24
1.7.4 Reimbursement and Patient's Access for Medical Imaging in the U.S. 24

2. Medical Imaging Technologies: A Brief Overview 26
2.1 General X-rays in Medical Imaging 26
2.1.1 Applications 26
2.2 Computed Tomography (CT) in Medical Imaging 27
2.2.1 Milestones in X-Ray CT 27
2.2.2 Evolution of Multislice Spiral CT Scanning 27
2.2.3 Computed Tomography (CT) Applications 27
2.2.4 Main Drivers in X-ray CT 28
2.2.5 Detector Channels per CT 28
2.2.6 Advances in X-Ray CT 28
2.2.7 Scanning Procedure 28
2.2.8 Common Uses of CT Scanners 28
2.2.9 Benefits of CT Scanning 29
2.2.10 Risks Involved in CT Scanning 29
2.3 Magnetic Resonance Imaging (MRI) 29
2.3.1 Safety Measures 30
2.3.2 Magnets in MRI Scanners 30
2.3.3 Technology of MRI Scanner 31
2.3.4 Visualization in MRI Scanner 31
2.3.5 Advantages of MRI 31
2.3.6 Disadvantages of MRI 32
2.4 Positron Emission Tomography (PET) 32
2.4.1 Common Uses of PET 32
2.4.2 PET Procedure 33
2.4.3 Benefits and Risks of PET Scans 33
2.4.4 Limitations of PET 33
2.4.5 Current Trends in PET and Hybrid Systems Design 33
2.4.6 Trends in PET Instrumentation 33
2.4.7 PET/CT 34
2.4.7.1 Advances in PET/CT Hybrid Modality 34
2.4.7.2 PET/CT Cancer Imaging 34
2.4.7.3 PET Neuroimaging 35
2.4.7.4 PET Cardiac Imaging 35
2.5 Single Photon Emission Computed Tomography (SPECT) 35
2.5.1 SPECT vs. PET 36
2.5.2 SPECT/CT Cancer Imaging 36
2.5.3 SPECT Neuroimaging 37
2.5.4 SPECT Cardiac Imaging 37
2.6 Ultrasound (US) 37
2.6.1 Ultrasound Machine 38
2.6.2 Different Types of Ultrasound 38
2.6.3 3D Ultrasound 38
2.6.4 Doppler Ultrasound 38
2.6.5 Uses of Ultrasound in Obstetrics and Gynecology 39
2.6.6 Uses of Ultrasound in Cardiology 39
2.6.7 Uses of Ultrasound in Urology 39
2.6.8 Ultrasound: Women's Preferred Imaging Modality 39
2.7 Mammography 39
2.7.1 Uses of Mammography 40
2.7.2 Mammography Equipment and Procedure 40
2.7.3 Benefits vs. Risks of Mammography 41
2.8 Fluoroscopy 41
2.9 Digital Radiography (DR) 42
2.10 Computed Radiography (CR) 42
2.11 Image-Guided Radiation Therapy 42
2.12 Cardiac CT Imaging 43
2.13 CT Angiography 43
2.14 Nuclear Medicine in Cardiac Imaging 44
2.15 Echocardiography in Cardiac Imaging 44
2.16 Optical Coherence Tomography (OCT) 44
2.17 Radioisotopes in Medicine 45
2.17.1 Diagnostic Techniques in Nuclear Medicine 45
2.17.2 Diagnostic Radiopharmaceuticals 46
2.17.3 Supplies of Radioisotopes 46
2.17.4 Contrast Media in Medical Imaging 47
2.17.5 Pricing Trends in Contrast Media 49
2.17.6 Economics of Contrast Agents 49
2.17.6.1 Reimbursement and Contrast Media 49
2.17.6.2 Negotiations on Pricing 49
2.17.7 Pricing in CT Contrast Agents 49
2.17.8 MRI Contrast Agents 50
2.17.8.1 Pricing in MRI Contrast Agents 51
2.17.9 Ultrasound Contrast Agents 52

3. Market Analysis 53
3.1 Medical Imaging and Information Technology Industry 53
3.2 Medical Imaging: Revenue Scenario in 2009 54
3.3 Popular Imaging Systems in 2009 54
3.4 Spending in IT Infrastructure 55
3.4.1 Clinical IT Spending 55
3.5 Global Market for Medical Imaging 55
3.5.1 Global Medical Imaging Market by Modality 56
3.6 Global Market for General X-Rays 57
3.7 Global Market for Ultrasound (US) 58
3.7.1 Global Market for Portable Ultrasound 59
3.8 Global Market for Magnetic Resonance Imaging (MRI) 60
3.9 Global Market for Computed Tomography (CT) 62
3.10 Global Market for Cardiovascular X-Ray 63
3.11 Global Market for Nuclear Medicine 64
3.11.1 Global Market for SPECT/PET 65
3.11.2 Long-Term Opportunities in SPECT in the Context of Technetium Shortage 67
3.11.3 High Energy Uranium (HEU) vs. Low Energy Uranium (LEU) 67
3.11.4 Effect of the Technetium Shortage on the SPECT Market 67
3.11.5 Improved Efficiency of New SPECT Cameras 67
3.11.6 New Radiopharmaceuticals in Nuclear Procedures 67
3.11.7 New Cardiology Products 68
3.12 Global Market for PET/CT 68
3.13 Global Oncology Biomarkers Market 69
3.15 Global Medical Displays and Post-Processing Software Market 72
3.15.1 Selected Medical Imaging Software 73
3.16 Global Market for Connectors in the Medical Electronics Market 73
3.17 North American Market for Medical Imaging 74
3.17.1 North American Market for Magnetic Resonance Imaging (MRI) 75
3.17.2 U.S. Market for Computed Tomography (CT) 76
3.17.3 U.S. Market for Multi-Slice CT Scanners 77
3.17.4 U.S. Market for SPECT and PET Radiopharmaceuticals 78
3.17.5.1 Medicare Payment for SPECT/CT Procedures in the U.S. 80
3.17.6 U.S. Market for Positron Emission Tomography (PET) 81
3.18 Radiology Practice in the U.S. 83
3.19 U.S. Market for Brachytherapy Products 84
3.20.2 Advances in Mammography in the U.S. 87
3.20.4 U.S. Market for Partial Breast Irradiation 88
3.20.5 Trends in Breast Cancer Mortality in the U.S 89
3.20.6 Medicare Reimbursement for Mammography Services in the U.S. 90
3.20.7 U.S. Market for Irradiated Microspheres for Liver Cancer 91
3.20.8 U.S. Market for Radiation Therapy 92
3.23 U.S. Market for Healthcare IT 102
3.23.1 EMR Adoption 102
3.23.2 Legitimacy of PHRs 103
3.23.3 Cost Containment 103
3.23.4 Emergence of Alternate Care Delivery Models 103
3.23.5 War on Medicare Fraud 103
3.23.6 Focus on Outbreak Preparedness 103
3.23.7 Intensification of Patient Safety Initiatives 103
3.23.8 Short Supply of Healthcare Professionals 103
3.23.9 Storage and Business Continuity Concerns 104
3.23.10 Physician Groups Joining Healthcare Systems 104
3.23.11 U.S. Market for Healthcare IT 104
3.23.12 Software Applications and Market in Medical Imaging 105
3.24 Medical Imaging in Canada 105
3.24.1 Funding for Medical Imaging Services in Canada 107
3.24.2 Medical Imaging Fees in Canada 107
3.24.3 Medical Imaging Market in Canada 108
3.24.4 Canadian Demand for Medical Imaging Products 109
3.24.5 Medical Imaging in Northern Canada 109
3.24.6 Nuclear Medicine in Canada 112
3.25 Medical Imaging in Europe 115
3.25.1 Growing Applications in Interventional Cardiology 115
3.25.2 Sluggish Growth of Cardiac MRI 116
3.25.3 Trend of Miniaturization and Echocardiography 116
3.25.4 Future of Medical Imaging in Europe 116
3.25.6 Picture Archiving and Communication Systems Market in Europe 117
3.25.7 European Market for Digital Radiography (DR) 118
3.25.8 European Market for Computed Radiography 119
3.25.9 European Market for MRI 119
3.25.10 Mammography in Europe 120
3.26 Emerging Markets in Medical Imaging 122
3.26.1 Medical Imaging in China and India 122
3.27 Medical Imaging Market in China 125
3.27.1 Market for Ultrasound in China 126
3.27.2 Multinational Medical Imaging Companies in China 127
3.28 Medical Imaging Market in India 127
3.28.1 Equipment Providers in India 128
3.28.2 Off-shoring of Radiology 128
3.28.3 Medical Imaging Industry in India 129
3.28.4 MRI Market in India 129
3.28.5 Nuclear Medicine in India 130
3.28.6 Indian Market for CT Systems 131
3.28.7 X-Ray Market in India 133
3.28.8 Digital Radiography in India 134
3.28.9 Cath Labs in India 135
3.28.10 Ultrasound Equipment Market in India 137
3.28.11 Endoscopy Equipment Market in India 139
3.28.12 Nuclear Medicine Equipment and Consumable Market in India 139

4. Funding Arrangements for Medical Imaging Procedures
4.1 The Working of the Systems 141
4.1.1 Waiting Times for Medical Imaging Procedures in Canada 141
4.1.2 Funding for Medical Imaging in France 142
4.1.3 Funding for Medical Imaging in Germany 142
4.1.4 Funding of Medical Imaging in New Zealand 143
4.1.5 Funding for Medical Imaging in the U.K. 144
4.1.6 Funding for Medical Imaging in the U.S. 146
4.1.7 Funding of Medical Imaging in Japan 149

5. Health and Medical Imaging Expenditures in OECD Countries 150
5.1 Diagnostic Imaging Equipment and Utilization Statistics 151
5.1.2 Gamma Cameras per Million of Population in OECD Countries 153
5.2 Utilization of Medical Imaging Modalities in OECD Countries 157

6. Company Profiles 161
6.1 3mensio Medical Imaging BV 161
6.2 Agfa HealthCare 161
6.3 Analogic Corporation 162
6.3.1 Computed Tomography Systems and Subsystems 162
6.3.2 Magnetic Resonance Imaging Power Solutions 162
6.3.3 Specialized Ultrasound Solutions 162
6.3.4 Digital Radiography Subsystems 163
6.3.5 Radiation Therapy Solutions 163
6.4 Ardent Sound, Inc 163
6.5 Avreo, Inc. 163
6.6 Bard Access Systems, Inc. 164
6.7 Biosound Esaote, Inc, 164
6.8 BK Medical 165
6.9 BRIT Systems, Inc. 166
6.10 Canon U.S.A., Inc. 166
6.11 Candelis 167
6.12 Cedaron Medical, Inc. 168
6.12.2 OrthoCare 168
6.13 Chison Medical Imaging, Co., Ltd. 168
6.14 DR Systems, Inc. 169
6.15 Focus Surgery, Inc. 170
6.15.1 Sonablate 170
6.16 Fonar Corporation 170
6.16.1 The Upright MRI 171
6.16.2 Fonar 360 171
6.17 Fujifilm Medical Systems USA, Inc. 171
6.18 Fukuda Denshi Co., Ltd. 172
6.19 GE Healthcare 173
6.20 Hitachi Medical Corporation 177
6.21 Hermes Medical Solutions 178
6.22 Hologic, Inc. 182
6.22.1 Hologic's Medical Imaging Product Offerings 182
6.22.1.1 Selenia Dimentions 2D Full Field Digital Mammography System 182
6.22.1.2 Screen-Film Mammography Systems 182
6.22.1.3 R2 ImageChecker Digital CAD 183
6.22.1.4 SecurView Diagnostic Workstations 183
6.22.1.5 Discovery 184
6.23 Imaging Diagnostic Systems, Inc. 184
6.23.1 CTLM 184
6.23.2 Invivo Corporation 185
6.23.3 DynaSuite Neuro 185
6.23.4 DynaCAD for Breast 185
6.23.5 DynaCAD for Prostate 186
6.24 InfiMed, Inc. 186
6.25 InSite One, Inc. 186
6.26 Intelerad Medical Systems 187
6.27 Konica Minolta Medical Imaging USA, Inc. 188
6.27.1 Regius Model 210 188
6.27.2 Xpress CR 189
6.27.3 Regius Nano CR 189
6.27.4 ImagePilot 189
6.27.5 IQue CR 190
6.27.6 FlexDR C30 190
6.27.7 Xpress DR Digital Radiography 190
6.28 Lantheus Medical Imaging, Inc. 191
6.29 Lumedx 191
6.30 MEDIAN Technologies S.A. 192
6.30.1 LMS-Lung 192
6.30.2 LMS-Lung/Track 192
6.30.3 LMS-Liver 193
6.31 Medis Medical Imaging Systems BV 193
6.32 Medison America, Inc. 194
6.33 Medtronic, Inc. 194
6.33.1 PoleStar 194
6.33.2 StealthStation i7 Integrated Surgical Navigation System 195
6.33.3 O-arm 195
6.33.4 StealthViz 195
6.34 NanoScan Imaging, LLC 195
6.34.1 N1177 196
6.35 NovaRad 196
6.36 The Phantom Laboratory 196
6.36.1 Catphan 197
6.36.2 Magphan 197
6.36.3 ADNI Magphan 197
6.36.4 Specphan 197
6.36.5 Rando 198
6.36.6 RSVP Phantom Head 198
6.36.7 RSVP Phantom Pelvis 198
6.36.8 Phantom Patient 199
6.36.9 Sectional Phantoms 199
6.36.10 Liqui-Phil 199
6.37 Philips Healthcare 200
6.38 Sectra Medical Systems S.L. 202
6.39 Schick Technologies, Inc. 203
6.40 ScImage, Inc. 204
6.41 Siemens Healthcare 205
6.42 Shimadzu Corporation 210
6.43 SonoSite, Inc. 211
6.44 Spacelabs Healthcare, Inc. 211
6.44.1 Sentinel 212
6.45 Syntermed, Inc. 212
6.45.1 Emory Cardiiac Toolbox 212
6.45.2 Syntermed Live 212
6.45.3 Nuclear Report Professional 212
6.45.4 NeuroQ 212
6.45.5 EQuAL 212
6.46 TeraMedica, Inc. 213
6.47 TeraRecon, Inc. 213
6.48 TomTec Imaging Systems GmbH 214
6.49 Toshiba America Medical Systems, Inc. 214
6.49.1 Infinix-i systems 214
6.49.4 Viamo 215
6.49.5 Radrex-i 216
6.50 UltraRAD Corporation 216
6.51 Varian Medical Systems, Inc. 217
6.52 Vepro 217
6.53 Vidar Systems Corporation 217
6.54 Vital Images, Inc 218
6.55 VuCOMP, Inc. 218
6.56 Xoran Technologies, Inc. 219

Appendix 1: Medical Imaging Technologies 221
Appendix 1.1: Ultrasound Systems 221
Appendix 1.2: Computed Tomography 222
Appendix 1.3: Magnetic Resonance Imaging (MRI) 222
Appendix 1.4: Digital X-Ray 223
Appendix 1.5: Positron Emission Tomography (PET) 224
Appendix 2: Current and Future Trends in Medical Imaging Electronics 226
Appendix 2.1: Power Management 226
Appendix 2.2: Miniaturization and Integration 226
Appendix 3: Supply of Medical Radioisotopes 228
Appendix 3.1: Potential for New Reactors 229
Appendix 3.2: Processing Capacities and Restraints 230
Appendix 4: Opportunities in the Middle East for Healthcare and Medical Imaging Products 232
Appendix 4.1: The Largest U.S. Customers in the Middle East Region 232
Appendix 4.2: U.S. Exports of Medical Imaging Products to the Middle East 233
Appendix 5: Value of Radiation Therapy and Medical Imaging 234
Appendix 5.1: Effective Use of Medical Radiation 235
Appendix 5.2: Innovations to Reduce Radiation Dose 235
Appendix 5.3: Innovations in CT Imaging 235
Appendix 5.4: Effectiveness of Radiation Therapy 236
Appendix 5.5: Efforts to Minimize Radiation Dose 237
Appendix 5.6: New Dose Check Features 237
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Figure 1.1: Major Drivers of Healthcare Costs in the U.S., 2010 22
Figure 1.2: Growth in Medicare Allowed Services and Charges for Medical Imaging in the U.S., 1995-2009 23
Figure 1.3: Hospital Imaging Volume Projections in the U.S., 2005-2015 25
Figure 3.1: Medical Imaging Markets by Region, 2009 56
Figure 3.2: Global Medical Imaging Market by Modality, 2009 57
Figure 3.3: Global Market for General X-Rays, 2009-2016 58
Figure 3.4: Global Market for Ultrasound, 2009-2016 59
Figure 3.5: Global Market for Portable Ultrasound Equipment, 2009-2014 60
Figure 3.6: Global Magnetic Resonance Imaging (MRI) Market by Geography, 2010 61
Figure 3.7: Global Market for MRI, 2009-2016 61
Figure 3.8: Global CT Market, 2004-2009 62
Figure 3.9: Global Market for Computed Tomography, 2009-2016 63
Figure 3.10: Global Market for Cardiovascular X-Ray, 2009-2016 64
Figure 3.11: Market for Nuclear Medicine, 2009-2016 65
Figure 3.12: Estimated Lifetime Risks for Alzheimer's by Age and Sex in the U.S. 66
Figure 3.13: Global Market for SPECT/PET, 2010-2015 66
Figure 3.14: Global Market for PET/CT, 2010-2015 68
Figure 3.15: Global Market for Biomarkers, 2009-2014 69
Figure 3.16: Biomarker Patent Filings by Type of Cancer, 2010 71
Figure 3.17: Global Market for Breast Cancer, 2009-2016 72
Figure 3.18: Global Market for Medical Displays and Post-Processing Software, 2009-2014 72
Figure 3.19: Global Market for Connectors in the Medical Electronics, 2009-2014 74
Figure 3.20: North American Market for Medical Imaging Equipment, 2009-2016 75
Figure 3.21: North American Market for Magnetic Resonance Imaging, 2010-2015 76
Figure 3.22: U.S. Market for Computed Tomography (CT), 2008-2015 77
Figure 3.23: Market for Multi Slice CT Systems in the U.S., 2008-2015 78
Figure 3.24: U.S. Market for Radiopharmaceuticals, 2009-2017 79
Figure 3.25: U.S. Market for SPECT, 2009-2017 80
Figure 3.26: U.S. Market for PET, 2009-2017 82
Figure 3.27: U.S. Market for Brachytherapy Products, 2008-2016 85
Figure 3.28: New Breast Cancer Incidence in North America, 2009-2017 86
Figure 3.29: U.S. Market for Mammography, 2008-2013 88
Figure 3.30: U.S. Market for Partial Breast Irradiation, 2008-2016 89
Figure 3.31: Age-Specific Death Rates Due to Breast Cancer by Age Group, U.S., 1996 and 2006 90
Figure 3.32: U.S. Market for Irradiated Microspheres for Liver Cancer, 2008-2016 92
Figure 3.33: Age-Specific Incidence Rate of Breast Cancer in U.K., 2007 94
Figure 3.34: U.S. Market for PACS, 2008-2015 95
Figure 3.35: Number of U.S. Hospitals with PACS Installed, 2000-2008 96
Figure 3.36: Number of U.S. Hospitals with Installed PACS, 2000-2008 96
Figure 3.37: Replacements and New PACS Purchases, 2000-2008 97
Figure 3.38: PACS Installation by Bed Size in the U.S., 2000-2008 98
Figure 3.39: PACS Modalities Installations in the U.S. Hospitals, 2005 and 2008 98
Figure 3.40: PACS Company Market Share, 2008 99
Figure 3.41: PACS Image Distribution in Hospital Departments, 2006-2008 100
Figure 3.42: PACS Images Accessibility by Physician, 2006-2008 101
Figure 3.43: RIS and PACS Interface, 2005-2008 102
Figure 3.44: U.S. Market for Healthcare IT, 2009-2014 104
Figure 3.45: U.S. Market for Software Applications, 2009-2014 105
Figure 3.46: Canadian Market for Medical Imaging Modalities, 2009-2014 106
Figure 3.47: Percent Distribution of Diagnostic Imaging Examinations in Canadian Hospitals, 2006 106
Figure 3.48: Medical Imaging Market Leaders and their Market Share in Canada, 2009 109
Figure 3.49: Types and Breakdown of Nuclear Medicine Procedures that Can be DoneUsing Tc-99m 113
Figure 3.50: Global Nuclear Medicine Market Share by Reactor, 2008 114
Figure 3.51: Percent Global Market for Tc-99m by Geography/Country and Doses 115
Figure 3.52: Western European Market for Medical Imaging Equipment, 2009-2016 116
Figure 3.53: Imaging Diagnostics Market in Central Europe, 2009-2012 117
Figure 3.54: European Market for PACS, 2009-2016 118
Figure 3.55: European Market for Digital Radiography, 2009-2016 118
Figure 3.56: European Market for Computed Radiography, 2009-2016 119
Figure 3.57: European Market for Magnetic Resonance Imaging (MRI), 2010-2015 120
Figure 3.58: Percentage of Causes of Death in Women 121
Figure 3.59: Diagnostic Imaging Market in Emerging Markets, 2009-2016 122
Figure 3.60: Diagnostic Imaging Equipment Installations in the Two Emerging Economies, 2009 123
Figure 3.61: Middle-class population as a % of the total population in India, 1998-2010 124
Figure 3.62: Market for Medical Imaging Equipment in Greater China, 2009-2016 125
Figure 3.63: Market for Ultrasound in China, 2009-2014 126
Figure 3.64: Market for Medical Imaging Equipment in India, 2009-2016 128
Figure 3.65: Number of MRI Units in India, 2009 129
Figure 3.66: Indian CT Systems Market by Value, 2009 132
Figure 3.67: Indian CT Systems Market by Unit, 2009 132
Figure 3.68: Market for X-Ray in India, 2006-2009 133
Figure 3.69: Indian X-Ray Equipment Market by Unit (%), 2009 135
Figure 3.70: Indian Market for Cath Labs by Value, 2008-2009 135
Figure 3.71: Indian Cath Lab Market by Units, 2008-2009 136
Figure 3.72: Indian Ultrasonic Equipment Market Share by Segment, 2007 137
Figure 3.73: Percent Indian Market Share in Endoscopy by Segment, 2009 139
Figure 3.74: Indian Market for PET Systems and Gamma Camera, 2009 140
Figure 5.1: Public and Private Expenditure on Health % of GDP in Select OECD Countries 150
Figure 5.2: Angiography Units per Million of Population in OECD Countries 151
Figure 5.3: CT Scanners per Million of Population in OED Countries 152
Figure 5.4: Gamma Cameras per Million of Population in OECD Countries 153
Figure 5.5: Mammography Units per Million of Population in OECD Countries 154
Figure 5.6: MRI Scanners per Million of Population in OECD Countries 155
Figure 5.7: PET Scanners per Million of Population in OECD Countries 156
Figure 5.8: CT Exams per Scanner in OECD Countries 157
Figure 5.9: CT Exams per 1,000 of Population in OECD Countries 158
Figure 5.10: MRI exams per Scanner in the OECD countries 159
Figure 5.11: MRI Exams per 1,000 of Population in OECD Countries 160
Figure App. 1.1: Block Diagram of Imaging Ultrasound Equipment 221
Figure App. 1.2: Block Diagram of a Medical CT System 222
Figure App. 1.3: Block Diagram of a Medical MRI 223
Figure App 1.4: Block Diagram of Digital X-Ray 224
Figure App. 1.5: Block Diagram for Positron Emission Tomography 225
Figure App 2.1: Block Diagram of Portable Ultrasound System 226
Figure App. 3.1: Current Supply and Demand for Medical Radioisotopes, 2010-2024 229
Figure App. 3.2: Percent Market Share of Medical Radioisotopes by Reactor, 2010 230
Figure App. 4.1: U.S. Exports of Medical Products to the Middle East, 1996-2009 232
Figure App. 4.2: U.S. Exports of Medical Products to Israel, Saudi Arabia and Turkey, 1996-2009 233
Figure App. 4.3: U.S. Exports of Medical Imaging Products to Israel, Saudi Arabia and Turkey, 1996-2009 233

Table 1.1: Code-Specific Impacts of CMS Medicare Physician Fee Schedule 21
Table 1.2: CT Technical Revenue: Breakeven at Various Levels of Utilization in the U.S. 24
Table 1.3: MRI Technical Revenue: Breakeven at Various Levels of Utilization in the U.S. 24
Table 1.4: Reimbursement Reductions and Effect on Contribution Margin in U.S. Outpatient Imaging 25
Table 2.1: Properties of Scintillation Crystals in PET Imaging Systems 34
Table 2.2: Radioisotopes Used in Medical Imaging 47
Table 2.3: Comparative Data on X-Ray Contrast Media 47
Table 2.4: Properties of Low and Iso-Osmolar Contrast Agents 48
Table 2.5: A Sample of Common Radiological Contrasting Agents and Discount Rates 50
Table 2.6: Common MRI Contrast Agents and Discount Rates 51
Table 2.7: Common Ultrasound Contrast Agents and Discount 52
Table 3.1: Top Ten Imaging Systems Purchased, 2006-2009 54
Table 3.2: IT Spending in the U.S. Hospitals, 2010-2015 55
Table 3.3: Biomarkers Used in Cancer Diagnosis 70
Table 3.4: Medicare Payment Rated for SPECT/CT Procedures in the U.S., 2010 81
Table 3.5: Medicare Reimbursement for PET Services in the U.S., 2010 83
Table 3.6: Female Breast Cancer Risk Factors 86
Table 3.7: FDA Approved Mammography Systems, Breast Tests and Breast Implants, 2000-2010 87
Table 3.8: Medicare Reimbursement for Mammography Procedures, 2009 91
Table 3.9: Mortality Rate in European Countries, 1989-2006 93
Table 3.10: Number of New Cases and Rates of Breast Cancer in the U.K., 2007 94
Table 3.11: Sources of Operating Funds for Medical Imaging Equipment in Canada, 2007 107
Table 3.12: Canadian Fee Structure for Medical Imaging Procedures 107
Table 3.13: Imaging Modalities Available in Whitehorse General Hospital 110
Table 3.14: Imaging Equipment in Watson Lake Hospital and the Health Centers 111
Table 3.15: Imaging Equipment in Stanton Territorial Hospital 111
Table 3.16: Diagnostic Imaging Equipment in Northern Territory Hospitals 112
Table 3.17: Imaging Technologies in the Qikiqtani General Hospital 112
Table 3.18: Diagnostic Imaging Equipment Installations in China and India, 2000-2009 123
Table 3.19: Availability of Medical Imaging Equipment per Million Populations in China and India, 2009 124
Table 3.20: Diagnostic Imaging Affordability in Emerging Economies 125
Table 3.21: Multinational Firms in China for Medical Imaging Products 127
Table 3.22: Installed Base of CT and MRI in India, China, Japan and Korea, 2010 129
Table 3.23: Medical Cyclotrons in India 130
Table 3.24: PET/CT Scanner Profile in India 131
Table 3.25: PET/CT Scanners: No. of Slices Used in India 131
Table 3.26: Imaging Protocols in PET/CT in India 131
Table 3.27: Drivers of X-Ray Industry in India 134
Table 3.28: Major Ultrasound Market Vendors in India 137
Table 3.29: Ultrasound Equipment Vendors in India 138
Table 4.1: Weeks Waited for Medical Imaging Procedures in Canada 142
Table 4.2: Reimbursement Rates for Medical Imaging Procedures in Germany 143
Table 4.3: Reimbursement Rates for Medical Imaging Procedures in New Zealand 144
Table 4.4: Non-Mandatory Tariffs for Medical imaging in the U.K, 2009-2010 145
Table 4.5: Number and Cost of Medical Imaging Services in the U.K., 2008-09 146
Table 4.6: Percent Distribution of Health Services Visit by Expected Source of Payment, U.S. 147
Table 4.7: Cost of MRI and PET in Different States and Cities in the U.S. 147
Table 6.1: 3mensio's Product Portfolio 161
Table 6.2: Agfa's Medical Imaging Products 161
Table 6.3: Ardent's Product Portfolio 163
Table 6.4: Avreo's Radiology Workflow Solutions 164
Table 6.5: Bard's Imaging Products 164
Table 6.6: Biosound Esaote's Ultrasound Systems 165
Table 6.7: BK Medical's Product Portfolio 165
Table 6.8: BRIT System's Healthcare IT Solutions 166
Table 6.9: Canon's Medical Imaging Products 167
Table 6.10: Candelis' Software Solutions for Medical Imaging 167
Table 6.11: Chison's Ultrasound Product Portfolio 169
Table 6.12: DR System's Healthcare IT Solutions 170
Table 6.13: Fujifilm Medical Systems' Product Portfolio 172
Table 6.14: Fakuda's Ultrasound Products 172
Table 6.15: GE Healthcare's Medical Imaging Modalities and Contrast Media 173
Table 6.16: Hitachi's Medical Imaging Product Portfolio 177
Table 6.17: Hermes' Medical Imaging Software Solutions 178
Table 6.18: InfiMed's Product Portfolio 186
Table 6.19: InSite One's Software Solutions 187
Table 6.20: Intelerad's Software Solutions 188
Table 6.21: Lantheus' Contrast Agent Products 191
Table 6.22: Lumedx's Cardiovascular Information System Solutions 191
Table 6.23: Medis' Software for Various Medical Imaging Modalities 193
Table 6.24: Medison's Medical Imaging Products 194
Table 6.25: NovaRad's Product Portfolio 196
Table 6.26: Philips' Computed Tomography Systems 200
Table 6.27: Philips' Nuclear Medicine Products 201
Table 6.28: Philips' Radiography Systems 201
Table 6.29: Philips' Radiography/Fluoroscopy (R/F) Products 202
Table 6.30: Philips' Magnetic Resonance Imaging (MRI) Systems 202
Table 6.31: Philips' Mammography Systems 202
Table 6.32: Spectra's Product Portfolio 203
Table 6.33: Schick's Product Portfolio in Medical Imaging 204
Table 6.34: Sclmage's Product Portfolio 205
Table 6.35: Siemens' Product Portfolio 206
Table 6.36: Shimadzu's Product Portfolio 210
Table 6.37: TeraMedica's Portfolio of Solutions and Products 213
Table 6.38: TeraRecon's Portfolio of Imaging Solutions 213
Table 6.39: TomTec's Product Portfolio 214
Table 6.40: UltraRAD's Product Portfolio 216
Table 6.41: Vepro's Product Portfolio 217
Table 6.42: Vidar's Product Portfolio 217
Table 6.43: Vital Images' Product Portfolio 218
Table App. 3.1: Major Current 99Mo Producing Reactors, 2010 228
Table App. 3.2: Potential Reactor-Based Projects for 99Mo Production, 2010-2024 229
Table App. 3.3: Processing Capacity of Major Reactors, 2010 230
Table App. 3.4: Demand Scenarios for 99Mo, 2010-2025 231
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