RSNA2013: Big Iron Blues

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You’d think Roentgen had just made his big discovery for all of the talk about radiography as a modality on the RSNA exhibit floor. The vendors, of course, can’t be faulted: By and large, they put their fingers in the wind and placed their bets on what will fly in a health-care economy in which sales are down, X-ray equipment is aging, and discounts are up. While I visited just a small fraction of the thousands of booths, work-flow optimization, back-filling product lines with more affordable versions of existing products, and 39 flavors of X-ray predominated.

It’s hard for a health-care writer to get too excited about the inching tool on FUJIFILM’S mobile FDR Go mobile X-ray unit, but if you are a tech trying to get into a tight space, these features impact the value proposition. Rob Fabrizio says Fuji had its eye on the health-care clinic with a brand-new, entry-level floor-mounted X-ray room. “A lot of hospitals are buying clinics and they do have smaller X-ray rooms,” he notes. Two new digital detectors—30 cm by 24 cm for the NICU and 17-in by 17-in—were new at the meeting.

Fujifilm also has news at the high end with AcSelerate, a general X-ray system with tomosynthesis applications for orthopedics and chest X-ray. After several years of relative silence on the topic of post-processing, Fuji is once again putting resources into its post-processing software for X-ray with an overhaul of its Dynamic Visualization solution featuring motion suppression and dual energy subtraction. “It never picked up like it should have, but the interest is there because of health-care reform,” Fabrizio says.

At the Konica Minolta booth, where we’ve come to expect the latest in printer technology, I found a new focus on what Ron Batas called “primary imaging.” Konica was showing a new 10-in by 12-in flat-panel detector for the NICU, a mobile X-ray unit that it sources from GE, and the handheld ultrasound introduced at last year’s meeting, the SONIMAGE P3 (for personal, portable, and point of care). “We see this replacing the stethoscope,” Batas says.

Don’t be surprised if K-M expands on this theme in coming years with tabletops or roll-around units that would be more relevant to radiologists. With its purchase of the medical division of Panasonic last year and its expertise in optics, Konica Minolta’s booth could be full of even more primary imaging stock next year.

This new practicality is being driven by several factors, Hermann Requardt, CEO of Siemens Healthcare, told members of the press at its annual media breakfast. The good news is that demand for services will be driven by the demographics of an aging population, but the aftermath of the debt crisis, cost pressure, and a shortage of qualified health-care professionals in emerging markets like China summarize the challenges.

“Accountable care, how do we get more value for the money?” Requardt asks. “This is not just a result of Obamacare, this is a global trend. Systems medicine, being excellent in both clinical and operations functions, it is these two arenas in which we have to enable our customers to provide excellence, but at a reasonable cost.”

That, in a nutshell, is the market reality—and the root of big iron’s malaise.