The battle is now between enhancing clinical diagnostics and improving cost and efficiency.

MRI is rapidly emerging as an alternative to traditional ionizing diagnostic techniques such as CT, X-ray, and ultrasound. Continuous advancements in technology, superior imaging capabilities, increasing incidence of chronic diseases, growing use of hybrid modalities with MRI, and rising demand in emerging markets represent major factors driving growth in the market.

Relatively lower penetration of technology juxtaposed with rising healthcare awareness and growing physician preference for MRI systems will help spur growth in developing markets. In the developed markets, replacement demand is expected to spur growth. Expanding applications of MRI in diagnosis of multiple sclerosis and Alzheimer's disease will also help drive growth in the coming years.

mri-equipmentIndian Market Dynamics

The Indian MRI equipment market is estimated at 1150 crore, at 230 units in 2015-16. The 1.5T continues to be popular with a 75 percent market share, with 3T systems constituting the balance. The 0.2T–0.5T is gradually exiting this segment. The Indian market has not yet procured any 7T system.

The market which saw a 45 percent increase in 2014-15 over 2013-14 saw a mere 12.5 percent increase in 2015-16, over 2014-15.

GE, Philips, and Siemens have a combined share of 95 percent in the Indian market; the balance is shared by Hitachi and Toshiba.

MRI equipment offering silent scan that makes the sound of an MR scan as silent as a whisper have gained popularity over the last couple of years. While providing excellent image quality, these systems ensure clinicians make a confident diagnosis.

The Department of IT's R&D laboratory SAMEER is scheduled to launch India's first MRI machine by 2018. The R&D laboratory is in an advanced stage of product development.

mri-equipmentChallenges

Despite numerous advances in MRI capabilities, economic factors remain the greatest threat to innovation in the coming years, especially as healthcare providers call on manufacturers for low-cost technology. The battle is now between enhancing clinical diagnostics and improving cost and efficiency.

Some other factors impeding market growth include high capital investment, lack of long-term data on use of MRI in patients, limited availability of venture capital, shortage of helium gas deposition, and declining reimbursement rates for MRI procedure. However, manufacturers are now more concerned about analyzing more applications and developing effective equipment with improved patient comfort, which is expected to reduce the impact of these restraining factors.

Future Horizons

Approximately 80 million MRI scans are conducted on 24,000 MRI scanners worldwide each year. In the United States alone, more than 40 million MRI scans are conducted each year. The second largest market, Japan, enjoys the best access with the highest number of systems per million people. In the world's most populous Asia-Pacific region, the compound annual growth rate for MRI is projected at 16 percent. Although the MRI market is well established in Europe and Asia, where a number of major manufacturers are also based, it is still in its infancy in developing countries. China, for example, is spending tremendously on MRI equipment for its hospitals and developing MRI manufacturing capability. To date, improvements in MRI images have been possible primarily with more powerful, better-designed magnets, and to a lesser degree with advanced electronics and software. The industry continues to pursue even more powerful magnets and refinements based on multiple sensors and processors. However, the resulting gains are forecasted to be marginal overall with little improvement in basic operation or patient experience.

Digital superconductor electronics, proven in metrology and wireless communications, provide significant benefits for medical imaging. Digital-RF transitions MRI to fully digital MRI with reduced scan times, improved image resolution, lower cost, enhanced safety, and improved accessibility to people worldwide. Digital-RF technology can be used to both modify existing MRI systems and develop new small, portable machines that can be operated safely in any environment. These portable MRIs could be taken to the patient – in the doctor's office, emergency room, or even on the battlefield in a military field hospital.

Dr Mona Bhatia,Head of Department,Fortis Escorts Heart Institute, New Delhi
Second Opinion
MRI Safe ?

With increasing longevity, many elderly patients have large joint reconstructions, joint replacements, spinal implants, prosthesis, and cardiac implants as ICDs and pacemakers. It is estimated that over 50 percent of these patients over 65 years of age with implants are likely to require an MRI scan during the next 10 years.

Implanted devices are not always an absolute contraindication for MRI. Implanted devices are classified as MR Safe if the item poses no known hazards; MR Conditional items that demonstrate safety within defined conditions; and MR Unsafe items that pose unacceptable risks to the patient, medical staff or other persons within the MR environment.

Patients with MR Safe and MR Conditional implants can undergo MRI. Due to safety concerns with lack of proper implant knowledge, patients with metallic medical implants or devices may potentially be denied an MRI scan. Today, there exist very few implants for which scanning is an absolute contraindication.

Hence, it becomes increasingly important that all medical implants be tested by their manufacturers for MR safety and labeled according to standardized terminology. Active implants contain a power source (cardiac pacemakers and spinal cord stimulators), while passive implants have no power source (aneurysm clips and replacement joints).

Scanning patients with implants need awareness of the possible hazards and defined limits on specific parameters as specific absorption rate (SAR). Given a large number of our patients have cardiac and orthopedic implants, we follow meticulous procedures. In the event of patients with pacemakers who need an MRI exam, we follow a specified methodology after verifying which type of pacemaker it is, and ensure that an MR Conditional pacemaker is switched in an MR-compatible mode in order to perform a risk-free examination eliminating possible hazards in the MRI environment.

Radiology experts today need to lead the change by changing perceptions and educating the referrers and technologists to ensure patient and device safety. Refusing a study is easy but taking the effort to ensure a safe MRI scan in patients with implants requires expert knowledge and procedural alterations for better patient care.

Dr Mona Bhatia
Head of Department
Fortis Escorts Heart Institute,
New Delhi

The quality and resolution of MRI have improved in the past two decades, primarily due to more powerful magnets. Electronics and imaging software have also improved as in other imaging technologies. At present, there is little that can be done to further improve the operation of the basic MRI system while significant limitations and challenges remain. Operating costs, installation complexity, and safety concerns need to be addressed. Scan time – arguably the most important factor in operating costs and patient concerns – has not improved in any meaningful way. Healthcare professionals are in agreement that shortening scan times while preserving image quality is the biggest game-changer.

Indian Market Dynamics is based on market research conducted by Medical Buyer in March 2016.


 

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