One would think that after attending the annual Chicago meeting of the Radiological Society of North America for 20 years off and on, a person would get a little jaded. Not so for Patricia Soto, administrator of the radiology department at 431-bed Memorial Sloan-Kettering Cancer Center in New York, who said she continues to attend year after year because there is always some eye-popping new device to see.
Driven in part by the digital revolution, the technology surrounding radiology is leaping forward at a dizzying speed, making last year's wonderment this year's everyday tool. So breakneck is the pace-and the accompanying cost of purchasing the newest technologies-that not-for-profit hospitals are increasingly opting to lease new equipment rather than purchase it outright, said Frederick Wolfert, president and chief executive officer of Healthcare Financial Services for GE Capital.
To help offer perspective on what the largest show in healthcare means for providers, Soto agreed to give Modern Healthcare a shopping tour of the exhibit floor.
In marketing terms, Sloan-Kettering is an early adopter of new technology. Except for mammography, the hospital is nearly filmless. Vendors vie to say that Sloan-Kettering chose their equipment, so the hospital tends to get good prices "because of who we are," Soto said. For example, two years ago the facility agreed to purchase one of the first PET/CT scanners in the world, then purchased a second, and is already upgrading the first. The hybrid imager, which fuses computed tomography and positron emission tomography to create a tool that some said is greater than the sum of the two parts, was introduced at the RSNA meeting in 2000 (Nov. 27, 2000, p. 48).
Despite Sloan-Kettering's lead position on the cutting edge of technology, Soto found two high-ticketed imaging devices among the 645 technical exhibits occupying 441,080 square feet of floor space on the exhibition floor that especially wowed her. Of course, both relied heavily on sophisticated software and both were exceedingly expensive, although the hospital continues to purchase its radiology equipment outright. One was an X-ray system that provides fluoroscopic images for interventional radiology procedures-minimally invasive procedures using guiding catheters to inch medical instruments into all parts of the body. The second was a nuclear camera that throws away the cumbersome gantry, a doughnutlike platform to which nuclear cameras usually are attached.
Soto does not attend the RSNA meeting with a shopping list. Rather, she said, the conference gives her an opportunity to see a lot of things in one place, what's new in technology and what has received recent Food and Drug Administration approval. But radiology equipment is not purchased in a day, she said.
Soto, part of a team of 40 radiologists and assorted radiology personnel from Sloan-Kettering, was one of nearly 60,000 attendees, including exhibitors, at the conference. As administrator of the department, Soto holds the purse strings and handles the bidding of new capital equipment, but she does not make decisions without the department chairwoman's approval, she said.
Although the radiology department works on a yearly budget, this year it did some long-range planning to project exactly what equipment it will need to replace in the next 10 years and when. That is what brought Soto to the GE Medical Systems booth to look at the Innova 4100 digital flat panel X-ray system for interventional radiology, approved by the FDA just days before the RSNA assembly began. Sloan-Kettering has three such devices, but the oldest is 8 years old and she is looking to replace it, she said.
All the major equipment manufacturers offer their own particular versions of such X-ray systems. Taking full advantage of digital technology, they capture 3-D videolike images of working arteries and blood vessels.
Soto said the five interventional radiologists at Sloan-Kettering also would look at versions of the equipment from Siemens Medical Solutions and Philips Medical Systems. Ultimately the purchasing decision will be up to them.
The next stop was the Philips booth, where Soto wanted to show off an example of the three Skylight nuclear imaging platforms that Sloan-Kettering already has agreed to purchase. They sell for about $450,000-about 20% more than conventional devices. The hospital is constructing rooms for them. Soto said the 8-year-old-plus models, similarly manufactured by ADAC, now a division of Philips, have "done very well," but it's time to replace them and she was impressed by the new models' space-saving technology and ease of operation.
Borrowing its technology from the automotive industry, the Skylight makes big use of robotics to move the cameras and lenses. Designed more with the technician than the radiologist in mind, the device saves backs by moving heavy equipment robotically and can be used on two patients at once. The gantry-free detectors also make it easier to get patients in and out.
"This is really neat," Soto said.