IHS Markit estimated the global mobile C-arm market at $932 million in 2018; unit shipments for flat panel detector mobile C-arm systems forecast to grow by 10.3% through to 2023. Speculation and uncertainty arises as to whether the innovative technology and imaging capabilities that 3D mobile C-arm systems offer, will offer similar growth opportunity as forecast for the digital mobile C-arm market.
3D mobile C-arms can be used for interoperative imaging
The key limitation in the adoption of 3D technology is the restricted use outside of speciality applications. 3D mobile C-arm imaging is used predominately for interoperative imaging. Primary applications of 3D mobile systems include imaging for joints, spinal fusion and fracture. The benefits of using 3D imaging in mobile C-arms are not applicable to standard vascular procedures. This is due to the inability for vessels to be imaged, restricting its use to spinal and orthopaedic surgery.
From a surgeon’s perspective, storage of 3D datasets can be of great advantage enabling documentation of a patient’s treatment for six months post-intervention. Therefore, should further intervention be required, or if complications were to occur, previous imaging and intervention data can be retrieved to better guide further intervention.
Spine applications performed by minimally invasive procedures in Germany generate demand for mobile 3D C-arms
The German market endorses spinal procedures that are performed by minimally invasive techniques, as such, the mobile 3D segment has shown positive growth in this market. On average, demand for 3D mobile C-arms annually equates to 20-30 units, with high-end hospitals striving to acquire a mobile 3D system to showcase their advanced technology and imaging capabilities. A key benefit of driving adoption of 3D technology is the enhanced navigation system capability for the user, a feature which 2D systems currently lack.
The Chinese market also demonstrates a strong demand for 3D mobile C-arm systems due to navigational features that enable improved clinical outcome and enhanced imaging facilities.
In contrast, the United States market is a challenging market for 3D mobile C-arm system manufacturers to penetrate due to domination of use the of Medtronic’s O-arm in minimally invasive spinal surgery, also offering navigational capabilities. Additionally, from a healthcare econometrics perspective, the United States market favours hybrid operating rooms and O-arms for spinal surgery.
The versatility in applications which 2D mobile C-arms offer is jeopardised
In the current healthcare economic climate, where financial administrators are controlling purchasing of medical imaging equipment, return on investment and versatility of procedures paramount in purchasing decisions. As a result, the higher associated cost of purchasing a mobile 3D C-arm system, alongside the reduced versatility in mobile C-arm applications, restricts mass installation of mobile 3D C-arm systems. The cost of one 3D system equates to four 2D mobile C-arms.
Prolonged image processing and acquisition time associated with 3D mobile C-arm systems also proves to be a hindrance in adoption of this technology, with higher patient throughput and quicker scanning times being a key priority to hospital facilities.
Lack of trained professionals to interpret 3D images
Conclusion: Ziehm Imaging continue to be ambassadors of 3D mobile C-arm technology and capitalize on their domestic market
Ziehm Imaging is the contender driving growth for the mobile 3D C-arm x-ray market; being the sole competitor in the market. University hospitals and high-end municipal hospitals in Germany equip themselves with 3D mobile C-arm systems to promote their state-of-the-art imaging facilities. Most large mobile C-arm tenders in Germany include one 3D system in order to achieve this. However, growth potential outside of Germany is questionable, with the most prospective mass market of the United States being impenetrable due to high usage and strong preference of Medtronic’s O-arms for spinal intervention.
IHS Markit will continue to follow these trends as part of our coverage of the X-ray intelligence service, including syndicated reports on mobile and mini C-arm, general radiography and fluoroscopy, interventional X-ray, mammography X-ray, dental X-ray, veterinary X-ray and flat panel detector supply. For more information, please Bhvita Jani at [email protected]
CMEF 2019 - Shanghai