Sweet 16: 16-Channel CT Systems Mix Functionality and Affordability

With certain healthcare technologies, high-specification models offering cutting-edge advanced features are marketed with great fanfare, and a perception sometimes develops that only those high-performance products have real value. More basic—though capable—models receive far less attention and may even be seen as less desirable.

Computed tomography is one of those technologies. Today’s top-of-the-line models have extraordinary capabilities, such as producing stunning 4-D images and scanning a beating heart. And hospitals have been under considerable pressure to adopt the latest technology.

But advanced CT capabilities aren’t used as often as might be thought. For example, while it might be assumed that every CT provider is overwhelmed with demand for cardiac studies, informally surveying radiology department managers shows that cardiac CT patient volumes are actually very low in most radiology departments and that it is not unusual for some expensive features to be underused. Furthermore, the economic realities of reduced reimbursement, higher patient copays, and preauthorization requirements mean that the number of CT scans being performed is declining. As a result, the overall revenue from CT is declining.

Hospitals need to recognize an important fact: For most studies, a lower-end system will suffice. This means that, by taking a judicious approach to their CT purchases, hospitals can achieve significant savings.

The least expensive systems available in the United States have 16 channels; these are the most common of the lower-end systems. Vendors also offer systems with 20, 32, or 40 channels, which perform about the same as 16-channel systems, but have advantages such as upgradability and the more recent technological features.

A look at device specifications shows that for most routine studies, the majority of 16-channel systems should produce images of the same quality as those of the 64-channel systems from the same manufacturer. On the other hand, lower-end systems have fewer features to reduce patient radiation dose, as well as only limited capability to perform advanced applications such as dynamic studies. But the reality is that for most routine uses, such features aren’t needed.

So for some facilities, a lower-specification system can be a useful and cost-saving alternative to a higher-channel system. A 16-channel scanner costs about $0.4 million on average, while a top-of-the-line system—what we generically call premium CT—costs around $1.5 million. The gap widens when service costs are taken into account: The average price of an annual service contract is $100,000 for a 16-channel system, compared to $170,000 for a premium system. 1 (For an explanation of the categories into which...