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REFERENCE CODE GDME1131CFR | PUBLICATION DATE DECEMBER 2014 NUCLEAR IMAGING - EU ANALYSIS AND MARKET FORECASTS

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REFERENCE CODE GDME1131CFR | PUBLICAT ION DATE DECEMBER 2014

NUCLEAR IMAGING - EU ANALYSIS AND MARKET FORECASTS

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NUCLEAR IMAGING- EU ANALYSIS AND MARKET FORECASTS

Executive Summary

Nuclear Imaging Market Overview

GlobalData estimates the EU5 nuclear imaging

market to have been worth $212.6 million in 2012

and $219.9 million in 2013. GlobalData estimates

that this market will be worth $308 million in 2020,

increasing at a Compound Annual Growth Rate

(CAGR) of 6% during the period of 2014 to 2020.

The key drivers for the nuclear imaging market are:

Aging population and increasing disease

prevalence

Increasing referring physician awareness

Increasing defensive medicine

Increasing patient awareness

Increasing self-referral behavior

Increasing implementation of comparative

effectiveness research

Improved accreditation of imaging facilities

Availability of new imaging reagents

Increasing demand for cancer diagnoses

Increasing demand for imaging-based

companion diagnostics

Replacement of positron emission tomography

(PET)/computed tomography (CT) by

PET/magnetic resonance imaging (MRI)

Replacement of single-photon emission

computed tomography (SPECT)-only systems

The key barriers of the nuclear imaging market are:

Legislation affecting reimbursements

The lobbying efforts of medical insurance

companies and consequent reduction in the

number of procedures performed

Greater scrutiny of electronic medical records

by healthcare payers, leading to a reduction in

the number of procedures performed.

Increased use of appropriateness criteria,

resulting in reduced examinations

Practice guidelines reducing unnecessary

procedures

Loss of nuclear medicine skills

High cost of instruments and reagents

Supply difficulties and increasing cost of radio-

pharmaceuticals

Hospital consolidation reducing the number of

scanning facilities

The nuclear imaging market is a moderately

growing market and a mature sector of the

diagnostic imaging market; continued growth is

expected along with continued technological

developments and the markets’ acceptance of

products.

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NUCLEAR IMAGING- EU ANALYSIS AND MARKET FORECASTS

Executive Summary

Below mentioned Table presents the key metrics of

the nuclear imaging industry during 2012-2020.

Nuclear Imaging Key Metrics: Key Events and Pipeline Assessment

2012 Market Sales ($m)

France $53.4m

Germany $75.2m

Italy $22.4m

Spain $29.5m

UK $32.1m

Total $212.6m

Key Events (2012–2020) Level of Impact

Approval by European Council on new EU Medical Device Regulations in 2015 ↑↑↑↑

Implementation of new EU Medical Device Regulations during 2018 to 2020 ↑↑↑↑

Conclusion of Philips PET Alpha Ring trials in 2014 ↑

GE Healthcare PET/CT & PET/MRI Comparison Trial 2014 ↑↑

Pipeline and Competitive Landscape Assessment

Total pipeline products profiled 11

Total companies profiled 26

2020 Market Sales ($m)

France $70.6m

Germany $102.2m

Italy $33.0m

Spain $51.9m

UK $50.4m

Total $308.2m Source: GlobalData, primary research interviews with leading nuclear medicine specialist in 5 markets (France, Germany, Italy, Spain, UK). 5EU = France, Germany, Italy, Spain, and UK.

Three Manufacturers Dominate the EU5 Nuclear Imaging Market

The market is dominated by three companies: the

market leader is GE Healthcare with around 44.5%

of the market by revenue, followed closely by

Siemens Healthcare with around 27.5% of the

market, and Philips Healthcare at 25%.

EU5 Nuclear Imaging Market in 2012

France25%

Germany35%Italy

11%

Spain14%

UK15%

Source: GlobalData 5EU = France, Germany, Italy, Spain, and UK

Future Outlook

The economic downturn has been a continued

concern within the whole of the diagnostic imaging

market. Indeed, the high cost of nuclear imaging

equipment and procedures has made the nuclear

imaging market more susceptible to the downturn.

The market growth for nuclear imaging in the EU is

heavily dependent on the replacement of already

existing systems because, as is the case in most of

the developed countries, the capacity for new

installations is limited. As the EU economies

recover, it can be expected that the equipment will

be replaced.

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NUCLEAR IMAGING- EU ANALYSIS AND MARKET FORECASTS

Executive Summary

However, at this point in time, the key opinion

leaders (KOLs) that GlobalData interviewed for this

report indicated that not all equipment is replaced

at the end of the average product lifecycle,

negatively affecting sales in the US and EU

markets.

The rising prevalence of disease, an aging

population, and a growing population will act as

major drivers of the increased use of nuclear

imaging. However, cost-containment measures

implemented by healthcare authorities will affect

which nuclear imaging technologies are favored.

What do Physicians Think?

GlobalData interviewed a number of KOLs in the

nuclear imaging setting; they discussed a wide

variety of points and concerns, providing insight

into clinicians’ view of the technologies found in

nuclear imaging, both existing and future. In

addition, the KOLs provided viewpoints into the

healthcare regimes related to nuclear imaging, and

how these might affect access to imaging.

Physicians provided insight into the major imaging

modalities, PET/CT, SPECT/CT and PET/MRI.

PET/CT will eventually replace many SPECT/CT

procedures, but this is dependent upon progress in

developing new radiotracer compounds.

“Whenever a tracer appears that can replace

SPECT/CT by PET/CT, SPECT/CT will tend to

disappear, but this will be a very slow [process]….

In the next ten years probably the number of

PET/CT examinations will [double] and those by

SPECT/CT [will halve].”

EU KOL

But there is still space for SPECT, provided that

the major manufacturer promotes it as a technique.

“[It’s] only very recently that manufacturers have

started promoting SPECT as a competitive tool. I’m

surprised; I don’t know why it took so long. Maybe

it’s because they were pretty overwhelmed in their

expanding PET market.”

EU KOL

While SPECT is well-established, SPECT/CT still

struggles to be reimbursed.

“Reimbursements are down, and specifically

talking about nuclear medicine, we have been

doing SPECT but there isn’t any reimbursement for

SPECT/CT; for those hybrid modalities… there

isn’t a separate reimbursement, and that is where

people are providing a service when needed and

doing SPECT/CTs, but not getting any additional

remuneration for these services provided.”

US KOL

Physicians remain to be convinced that PET/MRI

will revolutionize nuclear imaging.

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NUCLEAR IMAGING- EU ANALYSIS AND MARKET FORECASTS

Executive Summary

“The real question is whether, given the expense

and the complexity, if [PET/MRI] ever gets out of

the academic medical centers and into general

clinical practice. There hasn’t been an application

that really … justifies the complexity and the added

cost.”

US KOL

Stricter policies by insurance companies are

affecting patient access to nuclear imaging.

“More and more insurance companies are using

appropriateness criteria strictly, and regulating

access to PET/CT procedures especially the

cancer population….”

US KOL

US healthcare reforms may eventually increase

patient access to nuclear imaging, but may not

necessarily benefit the physician.

“As the effects of the Affordable Care Act kick

in…It may balance out where the volumes are

increasing, because more people have insurance,

but the reimbursements are going down.”

US KOL

Changes in reimbursement policies, leading to a

reduction in the number of nuclear imaging

procedures, are affecting hiring at hospitals and

leading to a potential loss of skills.

“These days they are hiring people with skills in the

rest of radiology, such as CT, MR, and not just

nuclear medicine, so that’s the reason why nuclear

medicine jobs are shrinking.”

US KOL

Ultimately, changes in reimbursement affecting the

career prospects of specialist physicians may also

result in the dilution of nuclear imaging skills might

affect the effectiveness of diagnosing disease.

“Radiologists who read PET/CT studies are also

not certified….. only have four months of nuclear

medicine, so imagine the life of a cancer patient or

a management position dependent on a person

who has had only four months of training in that

specialty.”

US KOL

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NUCLEAR IMAGING - EU ANALYSIS AND MARKET FORECASTS

1 Table of Contents

1 Table of Contents ....................................................................................................................... 6

1.1 List of Tables .................................................................................................................... 14

1.2 List of Figures ................................................................................................................... 18

2 Introduction ............................................................................................................................... 20

2.1 Catalyst ............................................................................................................................. 20

2.2 Related Reports ................................................................................................................ 20

3 Industry Overview ..................................................................................................................... 21

3.1 Nuclear Imaging Techniques ............................................................................................. 21

3.1.1 Positron Emission Tomography ..................................................................................... 21

3.1.2 Single-Photon Emission Computed Tomography .......................................................... 23

3.1.3 Planar Scintigraphy ....................................................................................................... 23

3.1.4 Hybrid Imaging .............................................................................................................. 24

3.2 Clinical Applications of Nuclear Imaging Technology ........................................................ 29

3.2.1 Cancer .......................................................................................................................... 29

3.2.2 Cardiology ..................................................................................................................... 31

3.2.3 Neurology ...................................................................................................................... 33

3.2.4 Infection and Inflammation ............................................................................................ 35

3.3 Advantages and Disadvantages of Nuclear Imaging Technologies ................................... 38

3.4 Market Access .................................................................................................................. 39

3.4.1 Product Life Cycle ......................................................................................................... 39

3.4.2 Purchasing Decisions .................................................................................................... 41

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3.4.3 Equipment Leasing........................................................................................................ 47

3.4.4 Replacement of PET/CT by PET/MRI............................................................................ 47

3.5 Reimbursement ................................................................................................................. 52

3.5.1 Overview ....................................................................................................................... 52

3.5.2 France ........................................................................................................................... 53

3.5.3 Germany ....................................................................................................................... 54

3.5.4 Italy ............................................................................................................................... 56

3.5.5 Spain ............................................................................................................................. 56

3.5.6 UK ................................................................................................................................. 57

3.6 Procedure Trends ............................................................................................................. 58

3.6.1 France ........................................................................................................................... 58

3.6.2 Germany ....................................................................................................................... 61

3.6.3 Italy ............................................................................................................................... 64

3.6.4 Spain ............................................................................................................................. 66

3.6.5 UK ................................................................................................................................. 68

3.7 Regulatory Issues/Recalls ................................................................................................. 71

3.8 M&As and Key Partnerships ............................................................................................. 71

3.9 Economic Impact .............................................................................................................. 74

4 Unmet Needs ............................................................................................................................ 75

4.1 Overview ........................................................................................................................... 75

4.2 Improved Reimbursement for New Techniques ................................................................. 75

4.3 Lack of Binding Clinical Guidelines ................................................................................... 79

4.4 Patient Comfort and Convenience..................................................................................... 79

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4.5 Reducing Radiation Exposure ........................................................................................... 80

4.6 Improved Scanner Performance ....................................................................................... 82

4.7 Image Processing Software Improvements ....................................................................... 83

4.8 Increased Risk of Artifacts in Hybrid Images ..................................................................... 85

4.9 Demand for New Radiotracers .......................................................................................... 86

4.10 Improved Clinical Input into the Design Process ............................................................... 88

5 Market Opportunity Analysis ..................................................................................................... 89

5.1 Cheaper, Simpler Nuclear Imaging Devices ...................................................................... 89

5.2 SPECT/CT in Developing Countries .................................................................................. 89

5.3 Increased Demand for Teleradiology Services .................................................................. 91

6 Market Drivers and Barriers ...................................................................................................... 93

6.1 Driver: Aging Population and Increasing Disease Prevalence ........................................... 93

6.2 Driver: Referring Physician Awareness ............................................................................. 94

6.3 Driver: Defensive medicine ............................................................................................... 95

6.4 Driver: Patient Awareness ................................................................................................. 97

6.5 Driver: Self-Referral .......................................................................................................... 97

6.6 Driver: New Imaging Agents.............................................................................................. 98

6.7 Driver: Increasing Demand for Cancer Diagnostic Tests ................................................... 98

6.8 Driver: Companion Diagnostic Testing .............................................................................. 99

6.9 Barrier: Comparative Effectiveness Research ................................................................. 100

6.10 Barrier: Reimbursement Legislation ................................................................................ 102

6.11 Barrier: Increasing Demand for Nuclear Imaging in Developing Markets ......................... 102

6.12 Barrier: Insurance Company Lobbying to Reduce Unnecessary Imaging ....................... 104

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6.13 Barrier: Greater Payer Scrutiny of EMRs ......................................................................... 104

6.14 Barrier: Increased Use of Appropriateness Criteria ......................................................... 105

6.15 Barrier: Practice Guidelines to Reduce Unnecessary Procedures ................................... 107

6.16 Barrier: Imaging Facility Accreditation ............................................................................. 107

6.17 Barrier: Loss of Nuclear Medicine Skills .......................................................................... 108

6.18 Barrier: High Cost of Instruments and Reagents ............................................................. 109

6.19 Barrier: Radiopharmaceutical Cost and Supply Difficulties .............................................. 110

6.20 Barrier: Hospital Consolidation ........................................................................................ 112

7 Competitive Assessment ........................................................................................................ 114

7.1 Overview ......................................................................................................................... 114

7.2 Dedicated PET Systems ................................................................................................. 114

7.2.1 Overview ..................................................................................................................... 114

7.2.2 Product Profile............................................................................................................. 115

7.2.3 SWOT Analysis ........................................................................................................... 116

7.3 PET/CT Systems ............................................................................................................ 116

7.3.1 Overview ..................................................................................................................... 116

7.3.2 Product Profiles ........................................................................................................... 117

7.3.3 SWOT Analysis ........................................................................................................... 119

7.4 PET/MRI Systems ........................................................................................................... 119

7.4.1 Overview ..................................................................................................................... 119

7.4.2 Product Profile............................................................................................................. 121

7.4.3 SWOT Analysis ........................................................................................................... 122

7.5 Dedicated SPECT Systems ............................................................................................ 122

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7.5.1 Overview ..................................................................................................................... 122

7.5.2 Product Profile............................................................................................................. 124

7.5.3 SWOT Analysis ........................................................................................................... 125

7.6 SPECT/CT Systems........................................................................................................ 126

7.6.1 Overview ..................................................................................................................... 126

7.6.2 Product Profile............................................................................................................. 128

7.6.3 SWOT Analysis ........................................................................................................... 129

7.7 PET/Ultrasound and SPECT/Ultrasound Systems .......................................................... 130

7.7.1 Overview ..................................................................................................................... 130

7.7.2 Product Profile............................................................................................................. 130

7.7.3 SWOT Analysis ........................................................................................................... 131

8 Pipeline Assessment............................................................................................................... 132

8.1 Overview ......................................................................................................................... 132

8.2 Pipeline by Phases in Development ................................................................................ 132

8.3 Product Profiles ............................................................................................................... 133

8.3.1 Brain Biosciences CerePET ........................................................................................ 133

8.3.2 ECORAD Dual Modality Imager .................................................................................. 134

8.3.3 FMI Technologies ScintiStar PET/CT .......................................................................... 135

8.3.4 IntraMedical Imaging Marginator Beta Camera ........................................................... 137

8.3.5 INSERT SPECT/MRI ................................................................................................... 138

8.3.6 Nucare/Zecotek Photonics New Generation PET Scanning Device ............................. 141

8.3.7 Philips Healthcare PET Alpha Ring Detector ............................................................... 142

8.3.8 Photo Diagnostic Systems NeuroPET/CT ................................................................... 143

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8.3.9 SynchroPET Breast PET/MRI ..................................................................................... 144

8.3.10 SynchroPET Wrist Scanner ......................................................................................... 145

8.3.11 SurgicEye SPECT Hybrid ............................................................................................ 146

9 Clinical Trials to Watch ........................................................................................................... 148

9.1 Overview ......................................................................................................................... 148

9.2 Clinical Trial Profiles........................................................................................................ 148

10 Current and Future Players ..................................................................................................... 151

10.1 Overview ......................................................................................................................... 151

10.2 Trends in Corporate Strategy .......................................................................................... 151

10.3 Company Profiles ............................................................................................................ 152

10.3.1 DDD-Diagnostic .......................................................................................................... 152

10.3.2 Digirad......................................................................................................................... 154

10.3.3 GE Healthcare............................................................................................................. 158

10.3.4 GVI Medical Devices ................................................................................................... 163

10.3.5 Mediso Medical Imaging Systems ............................................................................... 166

10.3.6 NeuroLogica ................................................................................................................ 168

10.3.7 Neusoft Medical Systems ............................................................................................ 170

10.3.8 NuCare Medical Systems ............................................................................................ 173

10.3.9 Oncovision .................................................................................................................. 175

10.3.10 Philips Healthcare ....................................................................................................... 177

10.3.11 Shimadzu .................................................................................................................... 184

10.3.12 Siemens Healthcare .................................................................................................... 189

10.3.13 SurgicEye .................................................................................................................... 194

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10.3.14 Toshiba Medical .......................................................................................................... 197

10.3.15 Other Companies ........................................................................................................ 202

11 Market Outlooks...................................................................................................................... 204

11.1 Company Market Share Analysis .................................................................................... 204

11.1.1 Overview ..................................................................................................................... 204

11.1.2 France ......................................................................................................................... 205

11.1.3 Germany ..................................................................................................................... 205

11.1.4 Italy ............................................................................................................................. 206

11.1.5 Spain ........................................................................................................................... 207

11.1.6 UK ............................................................................................................................... 208

11.2 Market Segment Share ................................................................................................... 208

11.2.1 SPECT & SPECT/CT .................................................................................................. 208

11.2.2 PET, PET/CT & PET/MRI ............................................................................................ 210

11.3 By Geography ................................................................................................................. 212

11.3.1 Overview ..................................................................................................................... 212

11.3.2 France ......................................................................................................................... 213

11.3.3 Germany ..................................................................................................................... 215

11.3.4 Italy ............................................................................................................................. 218

11.3.5 Spain ........................................................................................................................... 220

11.3.6 UK ............................................................................................................................... 223

12 Appendix................................................................................................................................. 227

12.1 Abbreviations .................................................................................................................. 227

12.2 Bibliography .................................................................................................................... 232

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12.3 Methodology ................................................................................................................... 261

12.3.1 Overview ..................................................................................................................... 261

12.3.2 Coverage .................................................................................................................... 261

12.3.3 Secondary Research ................................................................................................... 261

12.4 Physicians and Specialists Included in This Study .......................................................... 263

12.5 Primary Research ........................................................................................................... 265

12.5.1 Primary Research – Key Opinion Leader Interviews.................................................... 265

12.5.2 Expert Panel Validation ............................................................................................... 265

12.5.3 Stakeholder Survey ..................................................................................................... 266

12.6 Forecasting Methodology ................................................................................................ 268

12.7 About the Authors ........................................................................................................... 269

12.7.1 Andrew Thompson, PhD, Senior Analyst ..................................................................... 269

12.7.2 Priya Radhakrishnan, MBA, Director, Medical Devices ............................................... 269

12.7.3 Bonnie Bain, PhD, Global Head of Healthcare ............................................................ 270

12.8 About GlobalData ............................................................................................................ 271

12.9 Disclaimer ....................................................................................................................... 271

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1.1 List of Tables

Table 1: Applications of Nuclear Imaging ..................................................................................................... 29

Table 2: FDG-PET Diagnostic Accuracy for Specific Cancers ...................................................................... 30

Table 3: Potential Clinical Benefits of Hybrid Nuclear Imaging in Cardiology ................................................ 33

Table 4: Applications of PET Imaging in Non-Cancer Neurology .................................................................. 34

Table 5: Applications of SPECT Imaging in Non-Cancer Neurology ............................................................. 34

Table 6: Characteristics of SPECT, PET, Ultrasound, CT, and MRI ............................................................. 39

Table 7: The Age of Canada’s Hospital-Based Medical Technology Inventories, Relative to ECCREI Rules,

2009 .............................................................................................................................................. 40

Table 8: Nuclear Imaging Trends in France, 2012–2020 .............................................................................. 60

Table 9: Nuclear Imaging Trends in Germany, 2012–2020 ........................................................................... 63

Table 10: Nuclear Imaging Trends in Italy, 2012–2020................................................................................... 65

Table 11: Nuclear Imaging Trends in Spain, 2012–2020 ................................................................................ 67

Table 12: Nuclear Imaging Trends in UK, 2012–2020 .................................................................................... 70

Table 13: Recent Device Recalls in the Nuclear Imaging Market .................................................................... 71

Table 14: Recent Key Events in the Nuclear Imaging Market ......................................................................... 73

Table 15: Nuclear Imaging Market Drivers and Barriers ................................................................................. 93

Table 16: Duplicate Diagnostic Test Incidence in France, Germany, UK, and US ......................................... 105

Table 17: Dedicated PET Scanners ............................................................................................................. 115

Table 18: Dedicated PET SWOT Analysis ................................................................................................... 116

Table 19: PET/CT Scanners ........................................................................................................................ 117

Table 20: PET/CT SWOT Analysis .............................................................................................................. 119

Table 21: PET/MRI Systems........................................................................................................................ 121

Table 22: PET/MRI SWOT Analysis............................................................................................................. 122

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Table 23: Dedicated SPECT Systems ......................................................................................................... 124

Table 24: Dedicated SPECT SWOT Analysis .............................................................................................. 125

Table 25: SPECT/CT Systems .................................................................................................................... 128

Table 26: SPECT/CT SWOT Analysis ......................................................................................................... 129

Table 27: SPECT-Ultrasound Systems ........................................................................................................ 130

Table 28: SPECT/Ultrasound SWOT Analysis ............................................................................................. 131

Table 29: Nuclear Imaging Pipeline, 2014 .................................................................................................... 132

Table 30: CerePET SWOT Analysis ............................................................................................................ 134

Table 31: ECORAD Dual Modality Imager SWOT Analysis .......................................................................... 135

Table 32: ScintiStar PET/CT SWOT Analysis .............................................................................................. 137

Table 33: Marginator SWOT Analysis .......................................................................................................... 138

Table 34: INSERT SPECT-MRI SWOT Analysis .......................................................................................... 141

Table 35: Nucare/Zecotek Photonics New Generation PET Scanning Device SWOT Analysis ..................... 142

Table 36: PET Alpha Ring Detector ............................................................................................................. 143

Table 37: NeuroPET/CT Scanner SWOT Analysis ....................................................................................... 144

Table 38: SynchroPET Breast PET/MRI SWOT Analysis ............................................................................. 145

Table 39: SynchroPET Wrist Scanner .......................................................................................................... 146

Table 40: SurgicEye SPECT/Ultrasound device SWOT Analysis ................................................................. 147

Table 41: Key Clinical Trials ........................................................................................................................ 149

Table 42: Company Profile – DDD-Diagnostic ............................................................................................. 152

Table 43: DDD-Diagnostic SWOT Analysis .................................................................................................. 154

Table 44: Company Profile – Digirad ........................................................................................................... 155

Table 45: Digirad SWOT Analysis ................................................................................................................ 158

Table 46: Company Profile – GE Healthcare................................................................................................ 159

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Table 47: GE Healthcare Product Portfolio .................................................................................................. 160

Table 48: GE Healthcare SWOT Analysis .................................................................................................... 163

Table 49: Company Profile – GVI Medical Devices ...................................................................................... 164

Table 50: GVI Medical Devices SWOT Analysis .......................................................................................... 165

Table 51: Company Profile – Mediso Medical Imaging Systems ................................................................... 166

Table 52: Mediso Medical Imaging Systems SWOT Analysis ....................................................................... 167

Table 53: Company Profile – Neurologica .................................................................................................... 168

Table 54: Neurologica SWOT Analysis ........................................................................................................ 170

Table 55: Company Profile – Neusoft Medical Systems ............................................................................... 171

Table 56: Neusoft Medical Systems SWOT Analysis ................................................................................... 173

Table 57: Company Profile – NuCare Medical Systems ............................................................................... 174

Table 58: Nucare Medical Systems SWOT Analysis .................................................................................... 175

Table 59: Company Profile – Oncovision ..................................................................................................... 176

Table 60: Oncovision SWOT Analysis ......................................................................................................... 177

Table 61: Company Profile – Philips Healthcare .......................................................................................... 178

Table 62: Philips Healthcare SWOT Analysis ............................................................................................... 184

Table 63: Company Profile – Shimadzu ....................................................................................................... 185

Table 64: Shimadzu SWOT Analysis ........................................................................................................... 188

Table 65: Company Profile – Siemens Healthcare ....................................................................................... 189

Table 66: Siemens Healthcare SWOT Analysis ........................................................................................... 194

Table 67: Company Profile – SurgicEye....................................................................................................... 195

Table 68: SurgicEye SWOT Analysis ........................................................................................................... 197

Table 69: Company Profile – Toshiba Medical ............................................................................................. 198

Table 70: Toshiba Medical SWOT Analysis ................................................................................................. 201

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Table 71: Other Companies in the Nuclear Imaging Market, 2014 ................................................................ 202

Table 72: EU5 Market Value Forecast by Market Segment for SPECT & SPECT/CT (2012–2020)............... 209

Table 73: EU5 Market Value Forecast by Market Segment for PET, PET/CT & PET/MRI (2012–2020) ........ 211

Table 74: EU5 Sales of PET and SPECT Imaging Systems, 2012–2020 ...................................................... 213

Table 75: France Market Value Forecast by Market Sub segment (2012–2020) ........................................... 214

Table 76: Germany Market Value Forecast by Market Sub segment (2012–2020) ....................................... 216

Table 77: Italy Market Value Forecast by Market Sub-segment (2012–2020) ............................................... 218

Table 78: Spain Market Value Forecast by Market Sub-segment (2012–2020) ............................................. 221

Table 79: UK Market Value Forecast by Market Sub-segment (2012–2020) ................................................. 224

Table 80: Primary Research Summary ........................................................................................................ 266

Table 81: Primary Research Participants Affiliation ...................................................................................... 267

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1.2 List of Figures

Figure 1: Cyclotron Distribution in 10 Countries ........................................................................................... 22

Figure 2: Localization of Tumor in Chest Cavity by PET, CT, and PET/CT ................................................... 26

Figure 3: Mutually Beneficial Effects of PET/MRI Imaging ............................................................................ 28

Figure 4: Nuclear Imaging Trends in France, 2012–2020 ............................................................................. 60

Figure 5: Nuclear Imaging Trends in Germany, 2012–2020 ......................................................................... 63

Figure 6: Nuclear Imaging Trends in Italy, 2012–2020 ................................................................................. 65

Figure 7: Nuclear Imaging Trends in Spain, 2012–2020............................................................................... 67

Figure 8: Nuclear Imaging Trends in UK, 2012–2020................................................................................... 70

Figure 9: Imaging Utilization Rates (Number of Outpatient Visits with MRI/CT per 1,000 Persons), by Year in

the US .......................................................................................................................................... 94

Figure 10: EU5 Company Market Shares for Nuclear Imaging Equipment (2012) ........................................ 204

Figure 11: France Company Market Shares for Nuclear Imaging Equipment (2012) .................................... 205

Figure 12: Germany Company Market Shares for Nuclear Imaging Equipment (2012) ................................. 206

Figure 13: Italy Company Market Shares for Nuclear Imaging Equipment (2012) ......................................... 207

Figure 14: Spain Company Market Shares for Nuclear Imaging Equipment (2012) ...................................... 207

Figure 15: UK Company Market Shares for Nuclear Imaging Equipment (2012) .......................................... 208

Figure 16: EU5 Market Value Forecast by Market Segment for SPECT & SPECT/CT (2012–2020) ............. 209

Figure 17: EU5 Market Value Forecast by Market Segment for PET, PET/CT, and PET/MRI (2012–2020) .. 211

Figure 18: EU5 Sales of PET and SPECT Imaging Systems, 2012–2020 .................................................... 212

Figure 19: France Market Value Forecast by Market Subsegment (2012–2020) .......................................... 214

Figure 20: Germany Market Value Forecast by Market Sub segment (2012–2020) ...................................... 216

Figure 21: Italy Market Value Forecast by Market Sub segment (2012–2020) .............................................. 219

Figure 22: Spain Market Value Forecast by Market Sub-segment (2012–2020) ........................................... 222

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Figure 23: UK Market Value Forecast by Market Sub-segment (2012–2020) ............................................... 225

Figure 24: Primary Research Summary ....................................................................................................... 266

Figure 25: Primary Research Participants Affiliation .................................................................................... 267

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NUCLEAR IMAGING - EU ANALYSIS AND MARKET FORECASTS

Introduction

2 Introduction

An early diagnosis of disease is the foundation of increasing survival rates. Single-photon emission

computed tomography (SPECT) and positron emission tomography (PET) imaging are diagnostic

imaging techniques that are widely used in a variety of disease areas including oncology,

cardiovascular disease, bone disease, and infectious disease. This report provides an analysis of

the nuclear imaging market, with a particular focus on SPECT and PET imaging and hybrid

modalities within the 5EU (France, Germany, Italy, Spain, and UK). This report identifies the drivers

and barriers to nuclear imaging, as well as unmet needs in this market. This report also discusses

physician attitudes towards current diagnostic nuclear imaging modalities, and the future of nuclear

imaging in the face of rapid technological advancement and an increasingly challenging

reimbursement environment.

2.1 Catalyst

PET and SPECT imaging are well-established techniques in the nuclear imaging market. The

advent of hybrid imaging has enabled PET/CT imaging to undergo explosive growth, but this has

increased demand on struggling healthcare budgets. New developments in hybrid nuclear imaging

promise to further increase the utility of these technologies, while significantly improving patient

cost savings and safety by reducing the repeated or examinations. However, these improvements

come with a significant increase in the capital cost of equipment. This report examines how new

technologies can emerge in the face of healthcare reform and other economic pressures that may

affect the demand for nuclear imaging. Further, it focuses on the industry trends, promising pipeline

products, and competitive landscape of nuclear imaging.

2.2 Related Reports

GlobalData (2013). MediFocus: Future of Molecular Imaging, August, 2013, GDME002MFR.

GlobalData (2013). MediPoint: Breast Cancer Imaging – Global Analysis and Market

Forecasts, May, 2013, GDME0166MAR.

GlobalData (2014). MediPoint: Diagnostic Ultrasound Imaging - Global Analysis and Market

Forecasts, January 2014, GDME0182MAR.

GlobalData (2014). MediPoint: Diagnostic X-ray Imaging - Global Analysis and Market

Forecasts, July 2014, GDME0203MAR.

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NUCLEAR IMAGING - EU ANALYSIS AND MARKET FORECASTS

12.8 About GlobalData

GlobalData is a leading global provider of business intelligence in the Healthcare industry.

GlobalData provides its clients with up-to-date information and analysis on the latest developments

in drug research, disease analysis, and clinical research and development. Our integrated business

intelligence solutions include a range of interactive online databases, analytical tools, reports and

forecasts. Our analysis is supported by a 24/7 client support and analyst team.

GlobalData has offices in New York, San Francisco, Boston, London, India, Korea, Japan,

Singapore, and Australia.

12.9 Disclaimer

All Rights Reserved.

No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any

form by any means, electronic, mechanical, photocopying, recording, or otherwise, without the prior

permission of the publisher, GlobalData.