Used CT Equipment

In recent years, sales of used and refurbished CT equipment have increased steeply throughout the world. Historically, used and refurbished imaging equipment was purchased by medical facilities in third world countries and rural areas. In the mid-1990’s, with managed care perceived as a likely response to spiraling medical costs, demand increased in US urban areas as well as large US hospital chains began opting for used CT equipment.

A limited amount of relatively new CT equipment becomes available as top tier medical centers replace equipment in an effort to maintain a technology advantage over competitive health care facilities, and in order to provide physician-researchers with the cutting edge technology that they need to conduct novel studies. Larger quantities of used CT equipment has become available as medical centers and free-standing imaging centers have been shuttered or downscaled as a result of the economic downturn. Equipment from these centers is sold to raise funds for debt settlement and refurbished for resale.

On the demand side, medical centers in the US as well as around the world are seeking ways to maximize return on their medical equipment budgets. With used CT equipment generally available at half the cost of similar new equipment, purchasing used CT equipment is an ideal way to reduce the cost of providing important diagnostic services. The cost of a new CT can exceed a million dollars, while refurbished equipment may be sold for less than half the original price.

Used CT equipment is refurbished and offered for sale by major CT manufacturers such as GE and Siemens. A number of engineering service companies also refurbish the equipment for resale.

Equipment that is to be resold is inspected at the original site and de-installed. All performance records are examined for evidence of malfunctions. Only CTs for which replacement parts are available—and will continue to be available—are refurbished.

Once a CT has been determined to meet established criteria, it is shipped to a factory or workshop, where the used CT equipment is disassembled and thoroughly cleaned. Painted parts are touched up or repainted. Broken or worn parts are replaced with original replacement parts. System software is checked for bugs and updated to the most recent versions. Systems may be customized. Used CT equipment is tested thoroughly for safety and performance before being shipped to the purchaser’s site for installation.

Refurbished Medical Equipment

In recent years, a large aftermarket has emerged for medical devices and equipment that have been restored to safety and efficacy. The equipment is refurbished through a process of repairing worn and broken parts or replacing them with original parts, and updating software and electronics. Because no product specifications are altered during the refurbishment process, as for remanufactured products, refurbished products may be sold worldwide without obtaining special approvals. This has created a burgeoning international market in medical equipment and devices, distinct from the market in used—and unrestored—products, and remanufactured products.

The market is expanding at an annual rate of almost 8% annually. By 2017, annual sales of refurbished medical equipment are expected to reach almost $8.5 billion worldwide. Both OEM producers of medical devices and equipment and third party vendors are active in the market. Refurbished equipment is widely used in both developed countries and emerging economies, driven by pressure to contain healthcare costs and environmental concerns. An estimated one third of CT scanners in the US are refurbished.

The refurbishing process generally starts with inspection and de-installation at the site of the original equipment owner. The condition of the equipment is assessed and its performance history is reviewed. If the equipment meets the refurbishing company’s criteria, and if spare parts are available (and will remain available for at least a few more years), the equipment is de-installed by qualified technicians and shipped to a factory, in the case of OEM refurbishers, or to an engineering workshop.

At the factory or workshop, the equipment is fully disassembled, cleaned and disinfected. Parts are painted or their finishes are otherwise restored. All components are checked for wear and operability, and worn or nonfunctioning elements are replaced with original parts. All software and systems are updated. In many cases, systems will be customized to meet customer requirements. Finally, the equipment undergoes testing to ensure that it performs safely and accurately.

Once the restoration process is complete, the equipment is shipped to the purchaser’s site and installed. It undergoes an on-site testing process and, when necessary, safety certification. Some vendors provide training in the use of the new system. In most cases, refurbished equipment is sold under warranty and with a service contract.

An extremely wide range of medical equipment and devices are sold as refurbished, including diagnostic and imaging equipment, surgical equipment, monitoring devices and biotechnology instruments.

CT Scanner Parts

A CT scanner is a complex device that obtains large numbers of X-ray images from every point around numerous “slices” of a patient’s body. Complex algorithms are used to integrate the numerous images from the different vantage points into complete cross-sectional images of the patient’s body.

Refurbishing CT Scanners

Professionally refurbished CTs look and perform similarly to brand new devices. They offer medical centers and imaging centers of all sizes affordable solutions and outstanding value.
The performance, reliability and lifespan of a refurbished CT scanner depends on the condition of the scanner prior to refurbishing; the quality of replacement parts; the expertise of the technicians who work on it; and, finally, the thoroughness of the pre-sale testing process.

What is Image- Guided Radiotherapy (IGRT)?

How Image-Guided Radiotherapy (IGRT) Came to Be

Image-guided radiotherapy, or IGRT as it is commonly known, evolved from IMRT. IMRT provides far greater beam shaping capabilities than 3D radiation therapy, in this manner allowing more sophisticated and precise treatment. However, radiologists continued to require a safety margin for error for all treatments because of the intrinsic doubt of exact tumor location each and every day.  For example, the prostate moves in a multitude of directions each day depending on how full or empty the bladder and rectum are. In the past, even with IMRT, Drs would need to add a safety margin around the prostate to account for this day-to-day variability in prostate location.  This added margin resulted in a larger target (prostate) to be treated with radiation and more of the bladder and rectum included within the radiation field, thereby, increasing the risk of damage to these healthy organs. Image-guided radiotherapy (IGRT) has changed all of this. IGRT does exactly what its name states: it uses the image of the target to guide the delivery of radiation for each and every treatment. 

Image-Guided Radiotherapy (IGRT), the All-Digital Treatment System

Image-Guided Radiotherapy (IGRT), the all-digital treatment system, allows physicians to see a patient’s tumor in real- time at treatment, even if a tumor has moved - because of a patient's breathing, heartbeat, gastrointestinal changes or other activities. Tumors also change their position and their size during the course of radiotherapy treatment, which typically consists of multiple treatments over several weeks.

At the start of radiotherapy, technicians take a CT scan of a tumor and enter that data into a treatment-planning system. Image-Guided Radiotherapy IGRT software produces a three-dimensional, digitized image of the patient's tumor, sharply identifying the slightest contour. Once that image is captured, it can be recalled for every treatment session. If significant tumor movement has occurred, physicians can then adjust the patient's position or, if required, re-do the treatment plan, minimizing damage to surrounding healthy tissue.

 Why Use Image-Guided Radiotherapy (IGRT)?

With Image-Guided Radiotherapy (IGRT), physicians can match the radiation beam to the precise shape of your tumor far more precisely reducing the total amount of radiation you using built-in imaging technology at ultra-low doses.  The Image-Guided Radiotherapy (IGRT) reduces or eliminates the need for implanting markers, as physicians can visualize soft tissue detail using imaging tools. Tumors that were previously untreatable, because of their proximity to organs or the spinal cord can now receive treatment, which is a huge advance in treatment methods.

The MedWOW Image Guided Radiotherapy (IGRT) Solution

MedWOW features a comprehensive selection of new, used and refurbished radiology equipment, including complete image-guided radiotherapy (IGRT) systems by Nomos, especially the Nomos Bat Belfry.

As the largest global online marketplace for all kinds of medical equipment, MedWOW features a comprehensive searchable catalogue that allows you to filter for make, manufacturer, continent, condition, price range, seller’s business type, and other filters particular to radiology equipment.

If you don’t find the specific image-guided radiotherapy (IGRT) system you are looking for, you can post a free buying request which typically will bring you a number of competitive quotes from some of MedWOW’s worldwide sellers.

What You Need to Know About Your CT Scanner Gantry

In this continuing informational CT scanner blog series, this time we are discussing the CT scanner gantry. The CT scanner gantry is the doughnut-shaped part of the CT scanner that houses the apparatus necessary to produce and detect x-rays in order to create a CT image. The x-ray tube and detectors are positioned exactly opposite each other and rotate around the CT scanner gantry aperture. Continuous rotation in one direction without cable wrap around is possible due to the use of low-voltage slip rings.

By definition, a CT scanner gantry is a moveable frame that contains the x-ray tube, including: collimators and filters, detectors, data acquisition system, rotational components including slip ring systems, and all associated electronic accessories such as the CT scanner gantry angulation motors and positioning laser lights. The CT scanner gantry is the largest of all of the CT parts. The rotating frame, rotates at a speed of 100 – 200 RPM. A heavy x-ray tube is mounted on it, as well as a banana-shaped detector arch and other associated CT scanner gantry parts. Electric power, preconditioning lines and signal lines are provided by slipping rings. In the newer models, the signals are transmitted by a wireless system. The inclusion of slip ring technology into a CT system scanners allows for continuous scanning without cables getting in the way. A CT scanner gantry can be angled up to 30 degrees in both directions (forwards and backwards). CT scanner gantry angulation allows the operator to line up the part of the patient’s body which needs to be evaluated with the scanning plane, for precise imaging.

In the newer systems, the CT scanner gantry is continuously rotated to acquire important and comprehensive data, as the patient table is smoothly moved through the CT scanner gantry. The resulting route of the tube and detectors, in relation to the patient, forms a helical or spiral path. This powerful concept, called either helical CT or spiral CT, facilitates quick scans of entire regions of interest, in some cases within a few seconds. So significant were improvements in body CT quality and throughput that helical scanning became the standard of care for body CT scanners. This is very important for patients who suffer from claustrophobia.

Hospitals or imaging departments of healthcare facilities understand the importance of maintaining an up-to-date CT scanner gantry, as the technological advances allow great patient comfort, as well as much better imaging for diagnosis and treatment.

MedWOW has an enormous parts department, with a major focus on CT scanner gantries and other imaging equipment. If you need a replacement CT scanner gantry for your CT equipment, if it isn’t found on the MedWOW portal, the MedWOW parts finder team will conduct a thorough international search and find it for you.

There are currently nearly 2,000 CT scanner gantries parts available through the MedWOW marketplace, representing Esaote, GE Healthcare, Ige, Philips, Picker, Shimadzu, Siemens, Toshiba and other manufacturers. MedWOW’s search engines allow you to filter for make, model, price, condition, location and other variables.

The Technology of CT Scanner Detectors: from 1 to 256 Slices and Beyond

The CT scanner is made up of a complex combination of an x-ray source, detectors and computers, which produce high-resolution, cross-sectional images of the body. The patient lies on a table that passes through a gantry which resembles a donut hole, containing the x-ray tube and multiple detectors. The walls of the opening into the gantry are wedge-shaped, designed so that claustrophobia is not a considerable problem in most cases. A series of cross-sectional images are taken of the area to be examined in a matter of seconds. The raw data from the multiple detectors are then reconstructed by specially programmed computers, to present images of the internal structures of the area scanned.

Factors to Consider When Buying a CT Scanner

Technical specifications of available CT scanners are often quite extensive. Although it is helpful to review these for each CT scanner component, this may not reflect the relative clinical performance of the systems. It is also important to recognize that the performance in practice depends on the trade-off between image quality and radiation dose.

The time taken to complete a scan is a key factor in scanner performance and may limit the type of procedure that can be performed. In most cases, the limitation is set by the need to control artifacts due to involuntary patient motion, such as restlessness, or breathing and peristalsis.

CT Scanner design factors which affect the total scan time are the gantry rotation time and detector array design along the z-axis (scan axis).
The maximum scan length is governed by the z-axis detector array design, and the X-ray tube heat characteristics. With the large volumes of data generated with a 64 slice scanner, for example, the total scan length may also be limited by computer memory capacity.

The rotation time of the tube and the detectors around the patient has a direct effect on total scan time. Image quality will improve with faster rotation time, as there will be reduced misregistration of data arising from patient movement. This misregistration of data introduces artifacts into the image.

The length of the detector array determines the number of rotations needed to cover the total scan length, and thus the overall scan time. Multislice (MSCT) scanners cover a patient volume between 20 and 40 mm in length per rotation, and the latest diagnostic MSCT scanners can image patient volumes of up to 160 mm per rotation.

Complete coverage of an organ, such as the heart or the brain, offers advantages for both dynamic perfusion and cardiac studies. The z-axis detector array lengths of up to 80 mm on current scanners are adequate to cover these organs in only a few rotations. A coverage length of 160 mm usually allows complete organ coverage in a single rotation, so the function of the whole organ can be monitored over time.

Modern CT scanning techniques place a high heat load on the X-ray tube due to the need for high tube current values, in order to give enough photons in the image when scanning with fast rotations and fine slices. To scan a sufficiently long length, while avoiding overheating, X-ray tubes have generally been developed to have high anode heat capacities and high cooling rates. Some designs have low anode heat capacities, but very high cooling rates to compensate.

The principal parameters that describe image quality are: spatial resolution, contrast resolution, temporal resolution, and the prevalence of artifacts. The image quality actually achieved on any scanner depends not only on scanner design features, but also on scan parameters selected and patient-related factors, and will always be a compromise between image quality and radiation dose.

Modern MSCT scanners should be capable of achieving isotropic resolution: a z-axis resolution equal to, or approaching, the scan plane resolution, as this is essential for good quality multiplanar and 3D reconstructions.

Contrast resolution is the ability to resolve an object from its surroundings. The ability to detect an object will depend on its contrast, the image noise and the size.

Dose efficiency of the scanner is a significant factor in the examinations, as it will determine the dose required for a given level of contrast resolution.

In CT, temporal resolution is usually considered in the context of cardiac scanning. The aim is to minimize image artifacts due to the motion of the heart.

Generator power is an important factor in low-contrast examinations. Low noise images require high tube current values, particularly when coupled with fast rotation speeds and narrow slice acquisitions. Fast rotation speeds improve the temporal resolution and reduce movement artifacts.

Artifacts are defined as structures in the image that are not present in the object. An imaging system will invariably produce some level of artifact, but it becomes an issue if it obscures an abnormality, resulting in a false negative diagnosis, or mimics an abnormality, giving a false positive result.
Artifacts can be due to patient factors, scanner design factors or the reconstruction process, which by necessity involves some approximations.

Doses from CT examinations are generally significantly higher than those for conventional X-ray, although a CT scan provides more diagnostic information. The CT doses may be typically factors of 10s higher for standard head and abdomen examinations, and factors of 100s for chest examinations.