orr.jpg (8823 bytes)Radiology’s star continues to shine! The recently concluded annual RSNA meeting reported an impressive collection of medical advances and breaking-news developments that continue to change the course of medical diagnosis and therapy. While modern medicine would seem barbaric without non-invasive CT, MRI and ultrasound tools, the future medical imaging tools and applications appear equally impressive. So here is my one-page review of RSNA.

Imaging for Cancer
While most exhibitors focus on customers in their booths, the keynote RSNA speakers have always been carefully selected for enlightening the market on new and important trends in radiology. The topic of choice this year was oncologic imaging, as the opening session speaker Theresa McLoud, M.D., of Massachusetts General Hospital led a panel discussion on detection, staging, treatment planning and therapy follow-up. Imaging needs include almost every modality, with emerging requirements for 3D volume display and multiplanar imaging. Image detail is particularly important, as oncologists require anatomic location of a neoplasm (down to the cellular level), genetic-based extent of malignant progression and tumor physiology.

Early diagnosis continues to improve therapy and survival rates, and ex-smokers are now being targeted with a broad-based approach to improve the detection and treatment of lung cancer. Lung cancer is the second most common cancer among men and women, with relatively poor survival rates. Early and accurate detection is the big challenge, as imaging of the lungs needs substantial improvement from the current modalities. Lung-CT is capturing a substantial amount of publicity based on research by Claudia Henschke, M.D., of Cornell Medical Center, and this seems to be spurring other researchers into action as well.

If the message from this year’s meeting is that cancer diagnosis and treatment will likely be the major challenge of the 21st century, then imaging companies should find excellent business opportunities if they pursue a disease-based approach to new systems.

Cardiac Imaging
While the scientific side of RSNA focused on cancer imaging, the business side of the meeting was far more interested in cardiac imaging. The market for cardiac MRI and cardiac CT studies has accelerated rapidly during the past year, as system performance has finally crossed the threshold of practical clinical use. Billing is achievable for these studies, and the market for diagnosing cardiac disease dwarfs the cancer market. The net result is a surge of interest in the market that has caught most manufacturers (and radiologists) by surprise!

This opportunity creates a potential problem in paradise, as radiologists and cardiologists prepare to battle for control of these systems and procedures. Radiologists have formed the Committee on Cardiovascular Imaging, with meetings scheduled throughout 2000. Early predictions are that radiologists will control cardiac CT. Yet, cardiac MRI is a different matter. Radiologist memories are fairly recent regarding loss of control of many imaging procedures to disease or anatomic specialists, and this situation has many similarities.

Quick Takes
The Numbers – 60,000+ attendees (not much growth this year, if any), 3,000+ scientific papers, courses and posters (total overload), and more than 600 exhibit booths (changing the look, not growing).

Best Development – The Metra train from McCormick to downtown Chicago.

Least Development – Radiology-focused Web sites. AuntMinnie surged ahead, but the competition is boring among the dot.com crowd.

Nicest Surprise – R2 Technology’s CAD for mammography. Radiologists are voting with their pocketbooks, in surprising numbers.

Biggest Disappointment – Starbucks in the South Hall. Too much demand from this highly-caffeinated crowd caused a morning rush hour worse than any Chicago Expressway.

Most Creative Booth – Marconi Medical. The company wanted attention, they got it. Unfortunately, not all positive for their fortress-like booth (which was leased from athletic wear giant Reebok).

Tree-falling-in-a-forest award – Fonar.

Biggest crowd award – Tie: GE, Siemens, Philips, Agfa. 1 percent customers, 99 percent sales-people (OK, I’m exaggerating, but the RSNA expenses are sure steep).

Bloodied-not-beaten award – Digital X-Ray. Industry shakeout means better times ahead for the survivors. The images are getting better, now about those prices? end.gif (810 bytes)

Doug Orr, president of J&M Group (Ridgefield, Conn.), consults with medical device companies in strategy and business development for emerging growth markets, notably radiology and cardiology. Comments and suggestions can be sent to dforr@aol.com.