Hybrid imaging devices, such as SPECT/CT, are finding widespread acceptance within the clinical environment.

After a long period of depression and negative prospects, the field of nuclear medicine is experiencing a remarkable renaissance, with critically important developments in molecular diagnostics, therapeutics, and instrumentation. Much of this progress can be traced back to a more solid integration among the basic preclinical, translational, and clinical sciences and applications. Numerous translatable imaging probes are on the verge of clinical testing or even acceptance. Clinical molecular imaging now offers a large portfolio of diagnostic, prognostic, and predictive probes that measure the expression or inhibition of therapeutic targets or serve as intermediate endpoint biomarkers in various diseases.

Significant technological breakthroughs in imaging hardware and image-processing algorithms have been introduced. Recently PET tomography has improved lesion-detection capabilities through better contrast and spatial resolution performance. Parallel to these hardware developments, advanced implementations of image reconstruction algorithms have further improved image quality and quantitative performance. Associated developments include spatial resolution modeling, incorporation of prior object information in the reconstruction algorithms, better motion estimation and correction, and improved scatter correction.

Multimodality hybrid imaging has also accelerated the evolution of nuclear medicine thanks to the chance to acquire complementary information and create synergism by data fusion which may be needed to reach a definitive diagnostic conclusion, exclude certain pathologies, or obtain quantitative values and to plan therapeutic procedures and monitor treatment. As demonstrated by PET/CT in the oncology field, hybrid imaging devices, such as SPECT/CT, are finding widespread acceptance within the clinical environment and some are already contributing to patient care and management.

Global Scenario

Globally the nuclear medicine equipment market is expected to see attractive growth over the next few years owing to technological advancements, such as hybrid imaging, the launch of new radiopharmaceuticals to aid in therapy and diagnosis, and development of molecular imaging that does not require radioisotopes. A large disease burden associated with cancer is also expected to drive the market. According to the American Cancer Society, cancer is responsible for 1 in 8 deaths worldwide. People are conducting regular check-ups to look for symptoms associated with the disease, resulting in a rapid demand for nuclear medicine equipment.

The growth of nuclear medicine can also be attributed to the fact that it specifically delivers a unique and noninvasive approach to information at the molecular and cellular level, which is exclusive and cannot be reproduced using other imaging procedures. Additionally, it helps to detect the presence of disease in its earliest stages and is thus one of the most favorable drivers of the market, as public awareness about chronic diseases is increasing. Increasing diagnostic nuclear medicine procedures worldwide is predicted to have a positive impact in supporting the growth of the market in the coming years. The use of radiopharmaceuticals in diagnosis is growing at over 10 percent per year throughout the world.

The single photon emission computed tomography (SPECT) segment holds the largest share owing to low cost, better availability, and high usage when compared to positron emission tomography (PET). However, long scan times and
low-resolution images are expected to affect the growth of the SPECTs. On the other hand, PET is expected to overtake SPECT owing to its better features. PET has higher spatial resolution and offers a method to perform quantitative measurements even under maximum stress and speed levels.

Indian Market Dynamics

The Indian nuclear medicine equipment market in 2016 is estimated at
290 crore. GE dominates the segment and considers only gamma cameras/SPECT to be classified strictly as nuclear medicine, where it has an 83 percent market share. Siemens is the other strong contender. We have conservatively included PET scanners, which may also be used for molecular imaging, and cyclotrons also in this segment.

PET scanners have seen a major increase in demand from 10 units in 2015 to 36 in 2016, albeit the average unit prices have seen a decline. Cyclotrons continue to be procured as very discerning buys. This year two RF-based cyclotrons were procured, one in Bengaluru and the other in New Delhi.

Road Ahead

As the population ages and there is rise in multiple complex, chronic diseases, such as cancer, dementia, and cardiac diseases, physicians will find that they need more than just scanners to help provide accurate diagnoses and treatment. Features and capabilities in nuclear imaging solutions are expected to continue to evolve to fit the needs of physicians looking for better-quality imaging solutions, which will be critical to improving patient care. In addition to market-shaping factors noted earlier, there are three key trends that have emerged and are shaping the next generation of solutions, innovations, and breakthroughs:

  • Increased patient engagement is driving demand for data. As the industry continues to move toward more patient-centric care and patients become increasingly aware and more conscious of their health, there is a growing focus on early diagnosis and prevention.
  • Making personalized medicine a reality: As personalized medicine continues to influence how we deliver care, advances in nuclear medicine and molecular imaging technologies are making it more and more critical in the care continuum.
  • Integrated solutions for a 360 view of the patient: Clinicians are seeking more preemptive and definitive treatment programs, and are demanding access to integrated, comprehensive data on the patient's diagnostic history.

Extraordinary changes have occurred in nuclear medicine in a short time. Until today, positron-emitting tracers have become dominant and accepted as a routine adjunct in clinical practice, SPECT/CT still thrives and is finding extensive use, and clinical units and companies have become active and complementary in research endeavors and in some areas of clinical practice. In addition to PET/MRI, dedicated organ-based PET and conventional imaging systems are emerging. A true total-body PET system has been developed that will enable whole-body pharmacokinetic studies that are critically important in drug development. New opportunities are yet to be used for exploring disease and health at a molecular level and speeding novel discoveries from the laboratory to routine clinical use.

10 Diagnostic Imaging Trends for 2018



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