In 2008, the market for CT scanners in India was an estimated Rs. 300 crore, with cardiac and other high-end segment holding the major market share of approximately 35 percent.

Computed tomography (CT) has made a place for itself in the healthcare field by providing a non-invasive means of examining internal body structures and diagnosing disease. Although the field was nearing maturation several years ago, it has been significantly altered by evolving technology trends that have revitalized the industry.

Market Overview

In 2008, the market for CT scanners in India was an estimated Rs. 300 crore. Being high-cost equipment, CT scanner's market was impacted by the economic slowdown, which becomes evident on comparing total market value for CT scanner in 2007 with that of 2008. In 2007, the market value for CT scanners was an estimated Rs. 315 crore, whereas in 2008 the value dropped down to Rs. 300 crore.

The market for CT scanners can be segmented as follows:

• Cardiac and other high-end segment
• Non-cardiac and radiological high-end segment
• Value segment (2/4/6/8 slice CT)
• Entry level segment
• Refurbished/used equipment segment

Cardiac and other high-end segment accounted for the maximum market share (approximately 35 percent), valued at Rs. 104.7 crore. The value segment (2/4/6/8 slice CT) was observed to be not far, it was valued at Rs. 90.3 crore with approximately 30 percent market share. The remaining three segments non-cardiac and radiological high-end segment, entry level segment, and refurbished/used equipment segment had almost similar market size 12.9 percent, 10 percent, and 12.1 percent, respectively.

Although the overall market for CT experienced downturn, the refurbished equipment market has increased owing to the cheap alternative to high-end equipment.

In 2008, the CT scanner market was dominated by the presence of four major players, namely, GE Healthcare, Siemens, Toshiba, and Philips. The other major player in CT scanner market include: Blue Star Limited (market Hitachi), Cura Medical, Electromedicals, First Medical, Gabri International, Mars Medical, Masters Medical, Sanrad Medical, Shimadzu,. Most of these players are in the refurfished CT scanner market. Besides, medical technology solution providers like Carestream, Jindal Photo, and Sony, among others offers a range of medical films and film processing equipment (including imagers and printers).

Blue Star Limited markets Hitachi's CT scanners, it offers ECLOS CT scanner which can be upgraded from 4 to 8 to 16 slices. Cura Medical Equipment Pvt. Ltd. offers single-slice CT scanners and a family of multi-slice CT scanners. Electromedicals offers Holter monitoring systems and stress test systems. First Medical specialists of GE's, Toshiba's, and Siemens's. CT scanners. GE healthcare offers multi-slice CT scanners, HiSpeed series, LightSpeed series, and so on. Masters Medical Specializes in sourcing, procuring, and selling of used CT scanners and accessories. Philips Healthcare offers Brilliance range of CT scanners. Sanrad Medical specializes in sales and service of very high quality refurbished/reconditioned CT scanners. Siemens offer a range of CT scanners including SOMATOM series.

Cardiac CT and EBT represent an emerging niche within the traditional CT market. Both sectors are expected to focus on cardiac centers within hospitals, freestanding imaging centers, and new preventive screening centers. It is expected that the cardiac and preventive screening markets will provide additional momentum to revitalize the CT scanner market. Although these segments will not represent potential as vast as the radiology market, they will help to expand the installed base of CT scanners.

The multi-slice scanner has impressed end users by offering increases in the number of slices and sectional thinness, thereby nearing true volumetric scanning.

Cardiac imaging is a fast expanding CT application due to its utility in emergency medicine, perfusion studies and CT angiography

With the advent of portable and mobile CT scans, access and availability of this imaging modality has increased significantly. Rural hospitals and those with smaller budgets are now able to offer CT and other medical imaging to patients who previously had to travel elsewhere for this service.

Most of the CT heart scanners used in the country are the 64-slice ones that scan the heart within five heartbeats. The use of a single heartbeat 320 slice scan will result in greater reduction in radiation dosage.

Factors Driving Refurbished Equipment Market

The market for refurbished equipment is growing owing to low cost of the equipment. Refurbished equipment propels the end users to purchase latest technology products for their hospitals. Private healthcare institutions are also keen on investing in such equipment, but budgetary constraints prevent them from purchasing them. Hence, refurbished medical imaging equipment is likely to be the most viable and cheap alternative to high-end equipment for these institutions. As private healthcare institutions are key end users of refurbished equipment, anticipated growth in their number is likely to further strengthen the markets for refurbished medical imaging equipment.

Emerging Trends

Rapid upgrades in technology are transforming the computer tomography (CT) scanners landscape. The present multi-slice CTs allow 64 slices to be taken simultaneously at a high rotation speed of <400 ms, while spiral or helical systems permit faster scanning, making possible collection of full volume data in just a fraction of a second. Although the importance of prime competitive factors such as price, product features, and service is on the decline in the computed tomography market, pricing still dictates the single-slice CT scanner market share. Other than pricing, growth in the multi-slice CT scanner segment is determined by factors such as product development, product launch time, and customer loyalty. A key trend evident in the CT segment is the shift toward combination scanners, which are primarily hybrid scanners comprising positron emission tomographs (PET) and CT imaging capabilities.

Scan speed has also improved, resulting in a number of single-breath applications that until recently could not be performed with CT scanners.

Advances in Technology and Clinical Practice

Many CT systems are capable of imaging multiple slices simultaneously. Such advances allow relatively larger volumes of anatomy to be imaged in relatively less time. Another development in the technology is electron beam CT, also known as electron beam computed tomography (EBCT). Although the principle of creating cross-sectional images is the same as for conventional CT, whether single- or multi-slice, the EBCT scanner does not require any moving parts to generate the individual "snapshots". As a result, the EBCT scanner allows a quicker image acquisition than conventional CT scanners.

The technological innovations that have been made within the realm of CT over the past three years are revolutionary and should be the primary drivers for future industry growth.

It is expected that the cardiac and preventive screening markets will provide additional momentum to revitalize the CT scanner market. Although these segments will not represent potential as vast as the radiology market, they will help to expand the installed base of CT scanners. Cardiology and radiology fields are at the forefront of this technology, although the high-resolution, dynamic volume images are finding new applications in trauma and women's health, etc.

In a developing country like India, emerging medical markets provide good growth opportunities for CT, as economic growth, healthcare spending, and population size drive demand for high technology. Refurbished CT scanners account for a large majority of sales in these countries. Overall growth in medical imaging technologies will also fuel growth in picture archiving and communication systems (PACS) and radiology information systems (RIS).

Computed tomography has gone through rapid development during the past years, much of which was driven by the desire to provide reliable and accurate coronary angiography by CT. The advent of high speed, multi-channel CT scanners brought about significant changes in medical imaging, diagnosis, and treatment of patients. Faster scans have opened up new avenue for developing and expanding various clinical applications. CT scanners have now metamorphosed from being a primary diagnostic tool to an interventional system. Much bolder clinical applications are expected to be developed with technical advancement in real time imaging.