Greg Freiherr, Industry Consultant

Greg Freiherr has reported on developments in radiology since 1983. He runs the consulting service, The Freiherr Group.

Blog | Greg Freiherr, Industry Consultant | November 17, 2011

Slice Wars, Dose Wars…No Wars

Computed tomography (CT) is caught in the throes of an uneasy peace.  The war days, when the big four – Toshiba, Siemens, GE and Philips – fought for market share with mega-slice machines, are gone. It looked for a while that a war waged with dose reduction technologies might propel the industry forward, but it just hasn’t happened.

Slice wars propelled the industry – 4 slices, then 16, then 64 — with momentum sustained through a couple of half-steps in between. An abundance of 64-slice scanners, created by the last great surge in CT buying six years ago, satiated much of the appetite in the United States for new scanners. The result for vendors was an unnerving plunge that since 2006 has cut the $1.7 billion market for new CT units by more than half.

When the bottom fell out of the market, dose reared an ugly head and CT algorithms, initially developed to improve image quality, were leveraged to bring down patient radiation exposure. The most advanced of these were and continue to be computing-intensive. They render the best results when built into new systems rolling off production lines. But the installed base has not embraced dose-saving technologies as it did slices. And for good reason.

Many features designed to control patient X-ray dose had been onboard CT scanners for years. They simply weren’t being used very much. Just as we use only a fraction of the capabilities available to us in our word processing software, so had the radiology community overlooked many of the dose-cutting technologies that were right at their fingertips.

Increased awareness of these capabilities, and the need to use them, have led many in the community to adopt their use.  Upgrades – and the purchase of some new systems – have led to further reductions in dose. But the response to dose has been far from that to slices.

As we make plans again for our post-Thanksgiving pilgrimage to Chicago’s McCormick Place, we can expect to see dose reduction technologies bannered across the booths of RSNA exhibitors and talks by presenters. But those messages will be conveyed in an atmosphere of peace not war…much to the dismay of exhibitors.

 

Related Content

American College of Radiology Releases New Patient-Oriented Appropriateness Criteria Summaries
News | Patient Engagement | January 19, 2018
January 19, 2018 — New Appropriateness Criteria (AC) Patient Summaries from the American College of Radiology (ACR) c
National Clinical Decision Support Company (NDSC) has an exclusive deal with the American College of Radiology (ACR) to provide medical imaging appropriate use criteria (AUC).

National Clinical Decision Support Company (NDSC) has an exclusive deal with the American College of Radiology (ACR) to provide medical imaging appropriate use criteria (AUC). 

Feature | Clinical Decision Support | January 18, 2018
January 18, 2018 — Change Healthcare announced the acquisition of National Decision Support Company (NDSC), a leader
Hospital for Special Surgery Invests in Sectra Orthopedic 3-D Planning Software
News | Orthopedic Imaging | January 18, 2018
January 18, 2018 – International medical imaging IT and cybersecurity company Sectra announces that Hospital for Spec
Philips Introduces Technology Maximizer Program for Imaging Equipment Upgrades
Technology | Imaging | January 17, 2018
January 17, 2018 — Philips recently announced the launch of Technology Maximizer, a cross-modality program designed t
RSNA 2017 Celebrates Innovation in Radiology
News | Imaging | January 15, 2018
January 15, 2018 — The Radiological Society of North America’s...
Fat Distribution in Women and Men Provides Clues to Heart Attack Risk
News | Women's Health | January 11, 2018
January 11, 2018 – It’s not the amount of fat in your body but where it is stored that may increase your risk for hea
Emergency Radiologists See Inner Toll of Opioid Use Disorders

Rates of Imaging Positivity for IV-SUDs Complications. Image courtesy of Efren J. Flores, M.D.

News | Clinical Study | January 11, 2018
January 11, 2018 – Emergency radiologists are seeing a high prevalence of patients with complications related to opio
Minimally Invasive Treatment Provides Relief from Back Pain

Lumbar spine MRI showing disc herniation and nerve root at baseline and one month after treatment

News | Interventional Radiology | January 11, 2018
The majority of patients were pain free after receiving a new image-guided pulsed radiofrequency treatment for low back...
CT Shows Enlarged Aortas in Former Pro Football Players

3-D rendering from a cardiac CT dataset demonstrating mild dilation of the ascending aorta.

News | Computed Tomography (CT) | January 11, 2018
Former National Football League (NFL) players are more likely to have enlarged aortas, a condition that may put them at...

Size comparison between 3-D printed prosthesis implant and a penny.

News | 3-D Printing | January 11, 2018
January 11, 2018 — Researchers using...
Overlay Init