Proposal to Business Communications Company, Inc

Sample Proposal to Business Communications Company, Inc.

for a Report on Medical Imaging

Masha Zager

January 23, 2002

Report Abstract

The proposed report will update Business Communications Company, Inc.’s Report B-140, Medical Imaging: An Evolving Technology. It will review global markets for medical imaging products and will forecast trends and sales in these markets through 2007. Important manufacturers, technologies, and factors influencing demand will be discussed.

"Medical imaging products" are hardware, software, and supplies used to create, view, and manage visual images of non-visible organs of the human body for purposes of research, diagnosis, and guidance of non-invasive surgery. The report will focus on end-user markets including hospitals, research facilities, freestanding clinics, doctors’ offices, and equipment leasing companies.

The following well-established technologies will be included in the study: X-ray, including analog and digital X-ray; fluoroscopy, including standard and video fluoroscopy; magnetic resonance imaging (MRI), including standard MRI and functional MRI or MR fluoroscopy; computed tomography (CT), including standard CT, multislice or ultrafast CT, and electron beam tomography; single photon emission computed tomography (SPECT); positron emission tomography (PET); ultrasound, including 2-D and 3-D ultrasound; endoscopy, including fiberoptic endoscopy, video endoscopy, and ingestible cameras; and magnetic source imaging (MSI). In the last few years, several multimodal products have been developed in an attempt to combine the advantages of structural and functional imaging. Multimodal combinations currently on the market include CT/SPECT; CT/PET (Time Magazine’s "Medical Invention of the Year 2000"); MRI/MSI; and endoscopic ultrasound (EUS), combining fiberoptic endoscopy and ultrasound.

Emerging technologies that may be included in the study if it appears that they will be commercially significant by 2007 are: magnetic resonance spectroscopy (MRS); electrical impedance tomography (EIT); electrical source imaging (ESI); computerized thermal imaging; and laser optical imaging, including nonlinear optical multiphoton interferometric scanning microscopy, optical coherence-based imaging, optical spectro-scopic imaging, laser opto-acoustic tomography, and laser Doppler blood flow imaging.

Technologies excluded from the study are EEG and ECG, except when combined with one of the included technologies, and (non-computerized) thermal imaging.

Products used for radiotherapy, nonmedical imaging (e.g. in physics, chemistry, geology, and industry), and veterinary medicine will be excluded from the study to the extent possible.

Medical imaging products are usually sold bundled as systems for creating or managing images. Systems include some or all of the following: radiation source; radiation detector; patient table and gantry; computers and displays; robotic software; image acquisition software; image management software; virtual reality software; and computer-aided diagnostic software. Supplies and accessories will be discussed only if there is a significant aftermarket for them.

Report Outline

Table of Contents

Introduction

Summary

Overview: history and current state of medical imaging

Types of technologies: Transmission, reflection, and emission imaging

Types of applications: Research, diagnosis, and surgery

Types of analysis: Structural and functional

Growth in use of computers, digitized imaging, and data communications

Improvements in quality, effectiveness, and safety

Government regulation

Food and Drug Administration

Nuclear Regulatory Commission

Centers for Medicare & Medicaid Services (formerly HCFA)

State, local, and foreign government agencies

Industry structure

Major companies and market share

Major markets

Trends in price and price/performance

Other factors influencing demand:

Clinical guidelines issued by professional groups and insurers

Demographic changes

Market saturation

Training time

Technology, including patent evaluation

General technology issues

Image resolution

Image noise and artifacts

Image uniformity

Field of view – size, variability

Speed of image acquisition and generation

Risk/invasiveness

Radiation dose

Reaction to contrast media

Injury or infection

Patient comfort (including noise)

Overall exam time

Ease and reliability of operation

Detector stability

Open data communication standards (DICOM)

Technology issues by technology type

X-ray

Fluoroscopy

MRI

SPECT

PET

Ultrasound

Endoscopy

MSI

Other

Markets by product/technology types

Imaging Systems:

X-ray (analog)

X-ray (digital)

Fluoroscopy

Video fluoroscopy

CT (single slice)

CT (multislice)

CT (electron beam tomography)

MRI

Functional MRI

SPECT

PET

Ultrasound

Fiberoptic endoscopy

Video endoscopy

Ingestible cameras

MSI

CT/SPECT and CT/PET

MRI/MSI

Endoscopic ultrasound (EUS)

Image management systems:

Picture archiving and communication systems (PACS)

Virtual reality

Computer-aided diagnosis

Supplies and accessories with aftermarkets:

Film

Radioisotopes

Coils

Endoscopy accessory products

Contrast media?

Markets by application

Large-structure diagnosis

Neurology, brain research

Cardiovascular

Obstetrics

Mammography

Dentistry

Gastroenterology

Urology

Guidance for surgery

Other

Company profiles

Appendices

Conceptual Tables (Dummy Tables)

NOTE TO PROSPECTIVE AUTHORS: In your Step 4 proposal, you should submit a sufficient number of carefully composed "dummy" tables, so that we can evaluate the reasonableness of your proposed categories (e.g., your table row items) and your overall measurement scheme. (A typical finished BCC report has 30-50 tables.) In short, for Step 4, we need to know EXACTLY (or, as close you can come at this early stage) what you will be measuring during your approx. 3-month investigation. As you compose your dummy tables, please keep in mind that every BCC report is designed to tell how much of what is manufactured or consumed using which technologies, for what markets and in which applications, all by type and all with five-year forecasts. Also to be identified is, who is doing how much of what, how and why. Please see the BCC Author Guide for other report requirements.

1. SUMMARY TABLE
medical imaging user expenditures, through 2007

($ Millions)

	2000	2001	2002	2007	AAGR% 2002 – 2007

Medical imaging systems
Medical image management systems
Supplies and accessories
Other
Total

2. CMS (formerly HCFA) ACTIONS REGARDING MEDICAL IMAGING SINCE 1997

DATE	REG #	NEW PROCE-DURE ADDED	PROCEDURE DISALLOWED	DESCRIPTION
11/23/01	CMS-3077-N		v	PET scans disallowed unless scanners meet more stringent safety standards

3. manufacturers of X-ray systems

market share (Dollar sales), 2001
[similar tables for other types of systems]

Manufacturer	U.S. market share	Global market share
General Electric
Toshiba
Siemens
Etc.

4. number of medical imaging units in place, by location, 2001

	Number of units	Population	Units/population

United States
Europe
Japan
Canada, Australia, NZ
Other
Total

5. number of radiology professionals, by location, 2001

	Number of Radiologists	Number of Technicians	Population	Radiologists/population	Technicians/population

United States
Europe
Japan
Canada, Australia, NZ
Other
Total

6. price per study, by procedure type

[a study represents one patient session, during which several images may be produced. I plan to include several representative procedures, not necessarily those listed below. Data will probably be taken from HCFA reimbursements, unless alternative sources are identified.]

($)

	1991	2001	2002	2007	AAGR% 2002 – 2007

Chest X-ray
Mammography
Cardiac MRI
Obstetric ultrasound
Bronchoscopy
Etc.

7. MEDICAL IMAGING USER EXPENDITURES, BY LOCATION

($ Millions)

	2000	2001	2002	2007	AAGR% 2002 – 2007

United States
Europe
Japan
Canada, Australia, NZ
Other
Total

8. MEDICAL IMAGING USER EXPENDITURES, BY MARKET TYPE

(UNITED STATES)

($ Millions)

	2000	2001	2002	2007	AAGR% 2002 – 2007

Hospitals
Research laboratories
Diagnostic clinics
Doctors’ and dentists’ offices
Equipment leasing companies

9. HOSPITAL EXPENDITURES ON MEDICAL IMAGING, BY TECHNOLOGY TYPE (UNITED STATES)

($ Millions)

[similar tables for other market segments]

	2000	2001	2002	2007	AAGR% 2002 – 2007

X-ray systems
CT systems
MRI systems
Ultrasound systems
Endoscopy systems
PACS
Other
Total

10. HOSPITAL EXPENDITURES ON MEDICAL IMAGING SYSTEMS,

BY APPLICATION (UNITED STATES)

($ Millions)

[similar tables for other market segments]

	2000	2001	2002	2007	AAGR% 2002 – 2007

Neurology
Cardiology
Obstetrics
Oncology
Gastroenterology
Dentistry
Surgery
Other
Total

11. HOSPITAL EXPENDITURES ON CARDIOVASCULAR IMAGING SYSTEMS,

BY TECHNOLOGY (UNITED STATES)

($ Millions)

[similar tables for other market segments/applications]

	2000	2001	2002	2007	AAGR% 2002 – 2007
X-ray systems
CT scanners
MRI systems
SPECT systems
PET systems
Ultrasound systems
Other
Total

12. recent Patents and Patent Applications for medical imaging

Year	Institution/ Company	Title	Number	Description