Medical imaging: can the growth be sustained?

During the last decade the field of medical imaging has advanced by leaps and bounds facilitated by innovations in ultrasound, MRI, CT and PET technologies as well as dual modality approaches such as PET/MRI and PET/CT. These developments have allowed faster scanning and acquisition of clearer, coloured 3D images, whilst automatic dose regulation for imaging technologies involving ionizing radiation is inexorably lowering the dose to which patients are exposed. Use of ultrasound has expanded well beyond obstetrics, MRI is now routine in neurology, high speed CT imaging is the standard practice in cardiology and PET has become integral to modern oncology.
Both hospitals and patients have clearly benefited from all these innovations, with studies correlating use of relevant imaging modalities in accident and emergency departments with shorter patient waiting times and fewer hospital admissions. In the case of inpatients, use of medical imaging has been correlated with shorter hospital stays, a reduced need for exploratory surgery and a decline in mortality. Sadly, though, as financial problems continue to affect much of Europe as well as the US and Japan, the increasing costs incurred for medical imaging technology are becoming economically unsustainable. Is it possible to reduce these costs yet continue to deliver quality healthcare?
The purchase of refurbished rather than new equipment is increasingly becoming a prudent way for hospitals and clinics to reduce costs in the developed as well as less developed countries. Because technological advances have been so swift, larger (and wealthier) institutions may replace their quality MRI or CT systems with even more up to date models and