With a fluctuating and uncertain economy, many facilities are seeking imaging procedures that will spur growth. So what’s growing? Hand-held ultrasound system exams, virtual colonoscopy procedures and digital mammography studies, for starters. Health Imaging & IT talked with several industry watchers about which procedures are growing, for which applications and why.
Ultrasound: Portable power
The trend of taking ultrasound to patients rather than vice versa has been growing, says Lars Shaw, vice president of marketing for Zonare. Improvements in ultrasound resolution and penetration, and therefore confidence, has expanded use of the modality in traditional areas, such as ob/gyn and vascular applications. Newer areas, such as emergency care, critical care and surgery, are growing twice as fast or more than traditional markets, Shaw says. Overall, portable ultrasound has been growing by more than 20 percent a year and in 2007, use in emergency medicine increased 40 to 50 percent.
Dave Willis, vice president of innovation and competitive strategy for SonoSite, says people are “really starting to adapt ultrasound as a tool because it is a fairly inexpensive, noninvasive and safe modality to use as a guidance tool for interventional procedures.” Ultrasound can meet that need, he says, thanks to a combination of smaller, more affordable, more durable electronics. Another plus is that portable ultrasound is often done by physicians, rather than sonographers, who require good image quality, quickly, without a complicated user interface.
Terri Bresenham, vice president, global diagnostic ultrasound, GE Healthcare, says the newer specialties adopting ultrasound benefit from the addition of visualization in a low-cost, nonradiating approach. Ultrasound can improve the speed and quality of care and lower costs, she says.
Physicians typically do their own scanning in the European markets, Bresenham says, which provides a lot of efficiency because there is no delay between acquiring the scan and interpretation.
Current technological advances in the works are exciting, Bresenham says. The market is designing around specific clinician needs, she says, which is why GE currently offers eight different hand-carried ultrasound systems with more planned.
Sometimes patients—and clinicians—need convincing that the smaller units pack comparable clinical functionality as larger, more traditional sized units. Bigger doesn’t always mean better; smaller is far more convenient and, now, clinically effective, too.
Virtual colonoscopy to climb
What essentially amounts to a “seal of approval” from the American Cancer Society (ACS), along with growing awareness and better reimbursement puts virtual colonoscopy (VC) in a position to experience dramatic growth.
The recent endorsement by the ACS of VC as a colon cancer screening tool is crucial to the future of VC, says Peter Martin, PhD, director of business development, Colorectal Carecycle, Philips Healthcare. “We expect that if there is reimbursement by any of the major health insurance companies, that will actually drive a shift of people away from using only optical colonoscopy,” he says.
Currently, compliance with optical colonoscopy is believed to be less than half of the eligible population, at about 14 million screenings a year in the United States. Organizations are promoting colorectal cancer awareness and spreading the word that it is the only disease in which removing polyps can actually prevent cancer. That should increase acceptance of screening programs and “the hope is that will increase the total number of colonoscopies to around 20 million a year within the next few years,” says Scott Pohlman, director of CT clinical science for Philips Healthcare.
Colorectal cancer screening rates are much lower in Europe—about 15 percent of the eligible population. Some of that is due to less acceptance of the value of removing polyps, but again, there are indications of change. For example, Germany and the United Kingdom are launching national screening programs.
Another plus for VC is that any 16-slice or greater scanner is appropriate for the procedure. Currently, virtual colonoscopy procedures require the same bowel cleansing prep routine that patients dislike with the traditional optical method. However, software developments will cut the need for bowel cleansing as well as improve the extent of visualization of the bowel. A “fillet view” lets users view the 3D dataset as a cut-away cross