Growth SPECTulation

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Facing the prospect of lackluster growth over the next several years, the single photon emission computed tomography (SPECT) camera market is looking toward the advent of new imaging agents and molecular imaging to ignite interest in the technology and rescue it from the mire of sluggish sales.

The nuclear gamma camera market in recent years has been overshadowed by the swiftly growing PET (positron emission tomography) segment. The numbers tell the story best. Frost & Sullivan estimated the U.S. gamma camera market at $436 million in 2003, representing a growth rate of 8 percent. Nuclear cardiology accounted for approximately 26 percent of total U.S. revenues last year. In 2004, the market research firm's expectation is for very modest growth of 1 or 2 percent.

Looking to the next five years, depending on developments within the gamma camera market, Frost & Sullivan anticipates revenue growth between 3 percent and 7 percent, with domestic revenues in the range of $500 million in 2008.

"That [growth] is contingent upon the assumption that nothing major hits [the market] in the next few years," adds Monali Patel, Frost & Sullivan industry manager for imaging. The market could reach 7 percent with some outside help, such as current works-in-progress imaging agents coming to market by 2008.

WORLDWIDE OPPORTUNITIES

Worldwide gamma camera revenues reached $638 million in 2003, with a growth rate of approximately 6 percent. Frost & Sullivan's latest analysis sees worldwide gamma camera growth paralleling that of the United States in the 3 percent range.

The consensus among vendors and industry analysts is that there are current growth opportunities for gamma cameras in Asia and in China.

"There is tremendous growth in Asia, but, of course, everything grows in Asia right now," says Markus Lusser, vice president of global marketing and sales for gamma cameras and PET in Siemens Medical Solutions Nuclear Medicine Group. "[Asia] is growth market No. 1. China and India are picking up rapidly."

Nuclear cardiology remains a prime mover in the U.S. gamma camera market in terms of procedures. While nuclear cardiology represents approximately one-quarter of U.S. revenues, nuclear cardiology tallied 55 percent of all gamma camera procedures - 17 million to 18 million - in the United States in 2002, according to the most recent available number from Frost & Sullivan.

Nuclear cardiology, however, has leveled off somewhat in recent years, in terms of U.S. revenues, following its advance of the late 1990s and early this decade.

Still, Lusser sees some areas of strength in the U.S. market for more specialized systems, such as cardiac gamma cameras, "which indicate that more private imaging centers and cardiologists are getting interested in nuclear cardiology and are offering these kinds of services on their own premises."

CARDIOLOGY'S RISE

One reason for the ascent of the nuclear cardiology market in the mid- to late 1990s was the introduction of Cardiolite, the myocardial perfusion imaging agent launched by the former DuPont Pharmaceuticals and currently marketed by DuPont's current parent company, Bristol Myers Squibb. The former Amersham - now part of GE Healthcare Bio-Sciences - followed to market with the introduction of MyoView also for myocardial perfusion.

Now, the gamma camera market is keeping watch for additional imaging agents currently in development, which again will help boost sales and provide a bridge between the technology, molecular imaging and other expanded applications.

"Cardiology obviously continues to be the dominant sector within the market, but there is a lot of waiting to see if some of the new agents come to fruition in the next few years that could open the market to oncology," Patel says.

The nuclear cardiology market segment continues to be supported, in part, by physicians who establish cardiology services within their offices. The office-oriented purchases follow a general trend throughout medical imaging where cardiologists, oncologists and general physicians are expanding their imaging services.

The equipment options are single-head cameras, as well as dual-head systems, with fixed 90-degree angle cameras for cardiology imaging. The variable-angle cameras perform both nuclear cardiology studies, as well as general radiology exams, primarily for the hospital market.

"Over the years, we have seen the replacement of the single-head cameras by the variable-angle systems," notes Luke Liem, cardiology