For the past decade, innovations in computed tomography (CT) favored high end technologies. As utilization of CT services grew, the medical field demanded solutions that could answer new questions with greater image clarity and much less radiation. For a time, you could seemingly plot the trajectory of new CT technology on a steadily increasing slope: more slices and more cost.
 
That changed, however, with the Affordable Care Act in 2009 and the Protecting Access to Medicare Act of 2014. Providers began looking for ways to bring care closer to the patient while replacing outdated CT technology. Demand began to build for CT in relatively low-volume or routine-imaging settings. Anticipating these changes, Siemens released not one but two new 16-slice CT systems in 2014 — a move that may have prompted some CT luminaries to check their calendars for reassurances that they weren’t living in 2002. But for years, we observed steady market activity at 16 slices, and based on these new developments, we also could anticipate increased interest in 16-slice CT scanners that could address concerns involving patient proximity to care.
 
With broader population health initiatives, CT imaging is establishing a role in a more diverse array of clinical settings — most significantly, the intensified interest in early lung cancer detection is creating new opportunities for CT. By increasing access to CT scanning, a high-risk population of individuals could benefit from increased vigilance.
 





What stymies many early detection efforts, however, is the inability of the medical community to persuade reluctant patients to come in for evaluations. As hospitals and health systems consider how to approach the health and well-being of their populations going forward, the ability to deliver early detection outside of hospital walls will become increasingly important. Last year, Siemens introduced a 16-slice CT system — the SOMATOM Scope — that is so small it can be sited on a mobile vehicle the size of a common RV. Since this type of vehicle does not require a commercial driver’s license, we can reduce the complexity of bringing CT imaging to a broader population. This type of out-of-the-box thinking may become increasingly attractive for health care facilities.
 
Undoubtedly, another hot trend in CT has been dual-energy (DE) acquisition. While DE, like the 16-slice scanner, isn’t new — Siemens pioneered the DE concept in 2005 with our dual-source CT systems — wider adoption of DE has been historically hampered by lack of availability (in many cases, this was limited to high-end scanners only) and issues pertaining to a cumbersome workflow. That’s unfortunate, as DE has many clinical advantages, particularly in abdominal imaging, where diagnosing liver lesions can be difficult.
 
With DE, only one study is performed, but a wealth of information can be generated. For example, a virtual unenhanced data set (simulating a non-contrast study) can be acquired, and iodine maps can be overlaid onto the image to look at the enhancement patterns. Responding to growing interest in DE, Siemens now makes DE available not only at the high end of our portfolio but also on many of our new CT scanners, including 16-slice systems.
 




As health care facilities look to their fleets of CT scanners, they must expand their focus beyond today’s needs to identify solutions that will deliver the clinical functionalities and ease of access that future patients and physicians will demand. Sometimes, they may even find that the best solutions take their cue from new approaches to previously introduced innovations. But by expanding their focus, they won’t find themselves regretting the purchasing decisions they’ve made five years hence. Instead, they’ll radiate a professional confidence that stems from knowing that they chose the best value at the time — with the right capabilities to ensure years of valuable clinical use.

Murat Gungor is Vice President, CT Business Line, Siemens Healthcare