Among the various markets for radiation detection equipment, by far the largest is medical and healthcare applications, accounting for two-thirds of this sector. On the one hand it's a relatively established end market with clearly addressable usage cases. On the other hand, growth rates aren't as high as in other sectors such as domestic security or certain industrial processes, which require (often specialized) environmental monitoring capabilities.

Nevertheless, we see the medical and healthcare sector remaining a primary revenue generator for suppliers of radiation detection technologies. The market for X-ray imaging systems continues to be very strong for detecting low to high-energy photons coming out of tissues or bones (biological samples), especially in developing nations where these tests are cost-effective, efficient and quick.

We envision growth mainly will be for X-ray and for neutron systems. Gamma ray imaging has long been used in medical applications — apart from nuclear imaging systems, no other modality including radiology can aid in identifying malignancy — but we see more broadly its use in radiography as diminishing.

Application Opportunities for Radiation Detection

First, let's look at some specific usage trends we see as positive for radiation detection systems:

Smaller and Portable:  Device characteristics are moving towards smaller systems with embedded electronics that will eventually improve the portability and handiness of devices. This is in line with the worldwide trend to bring both diagnostic and therapeutic equipment closer to the patient.

The overall trend of “universality” — mobility of a system between rooms and setups, including wireless capabilities, and in varying cassettes sizes — was a prominent theme at the December 2014 annual meeting of the Radiological Society of North America (RSNA). We agree that this is a key pathway for suppliers to invest in, transporting some more advanced X-ray applications to more portable formats.

Another important micro-trend in this area is the introduction of smaller and lighter format detectors for easier imaging of smaller anatomies. In the U.S., companies such as Carestream and Fujifilm Medical Systems have received FDA clearance for wireless detectors and new contrast agents (gadolinium, and cesium detectors respectively).

Digital Radiography vs. X-ray:  Digital radiography (DR), a form of 2-dimensional X-ray imaging using digital sensors, continues to replace X-ray film technology owing to its better results and possibility of storing electronic data. DR is the next-level technological advancement poised to take center stage in all applications of non-destructive radiographic testing. It will play a vital role in shaping the market for radiography in the healthcare sector, becoming a natural choice for hospitals and clinics which boast of faster and improved response.

NanoMarkets believes DR's technological advantages are its primary market growth drivers:

The advent of new technologies is encouraging hospitals and other medical establishments to shift to digital X-ray systems. These medical centers are continuously adapting to provide better services for their patients. The growing number of medical facilities in developed and emerging economies is complementing the growth of radiographic testing.

Technological advances in automation, growing aging population, and need for improved and faster imaging methods for higher patient throughput which are not offered by either CR or films

Less radiation exposure to patient as well as radiologists is stressed by DR manufacturers, particularly in new markets.

Universal growth in medical structure owing to aging populations, growing incidences of chronic disease like tuberculosis, pneumonia and gastrointestinal disorders, in both developed and developing countries.

Advanced applications, such as dual energy subtraction, could provide a clinical reason for choosing digital over conventional radiography by providing better image quality.

Logically, the cost-associated problem of DR is encouraging companies to look out for cost-effective solutions. Manufacturers have come up with a way out wherein analog X-ray systems can be turned into digital systems at a relatively cheaper price using retrofit kits, comprising a high-density solid scan system or flat-panel detectors.

Given the scale of X-ray radiography, NanoMarkets believes that DR will rule the charts in developed nations, while the market in developing countries is constricted by cost issues. Firms are coming with distinctive products in lieu of complete DR systems.

The Rise of 3D:  As part of the progression to digital imaging, NanoMarkets anticipates greater demand in 3D pixilated images taken from machines directly, while digitization of 2D information will decline.

3D-DEXA (dual-energy X-ray absorptiometry) allows a 3D model of the femur bone to be constructed from 2D images taken with a DEXA bone densitometer during routine femur exams. This provides key information about the bone status, including bone geometry, cortical bone thickness and bone mineral density in lower dose levels than CT scanners. The 3D analysis will be highly useful for physicians in understanding multiple components of femurs and this technology can be extended to other important bones of the body.

There is particular excitement over 3D mammography, or breast tomosynthesis, in which X-ray machines take pictures of thin slices of the breast from different angles and the overall image is reconstructed with computer software. (This process is similar to how a CT scanner produces images of structures inside the body.) Encouraging results continue to emerge about 3D mammography; results of several studies throughout 2014 suggest far better detection success not just with 3D mammography technology but using both digital mammography and tomosynthesis.

Cost issues associated with 3D will be weighed in the near future, but not in the long run — especially for 3D tomography, owing to the high-volume rise in breast analysis for general checkups and cancer screening. Hologic was the first company to receive FDA approval (in 2011) for 3D breast tomosynthesis, and received another FDA approval in 2013 for a “low-dose version.” Recently (Sept. 2014) GE also received the FDA's nod for its low-dose 3D system.

Slicing and dicing:  One of the biggest trends in CT technology is shifting towards multidetector CTs (MDCT), in which a two-dimensional (2D) array of detector elements replaces the linear array of detector elements used in typical conventional and helical scanners. This 2D detector array permits CT scanners to acquire multiple slices or sections simultaneously and greatly increases the speed of image acquisition.

Image reconstruction in MDCT is more complicated than that in a single section. Nonetheless, the development of MDCT has resulted in the development of high-resolution applications such as CT angiography and colonoscopy. MDCT offer substantial improvement in volume coverage and scan speed with efficient use of X-ray tube which are replacing a single row of detectors.

Technology Opportunities for Radiation Detection

Here's a snapshot of what we see as the leading technology trends:

More Combinatorial Diagnosis:  The development of efficient combinatorial diagnosis and easier accessibility to healthcare procedures throughout the world continues to result in greater utilization of radiation detection systems. The market for detectors has also benefited from advancements in the science of radiology and from better understanding of device and diagnostic systems by medical professionals. An increasing number of clinical applications are being based on multimodal imaging systems (MIS) including anatomical (CT, MRI) and functional (PET, SPECT) techniques to provide complex information in a single image.

NanoMarkets believes that these next-generation systems will play a vital role in the diagnostic industry. Though, at present they have a small market size but with continual advancements and lowering of prices, reasonable opportunities are possible with both SPECT and PET combinations. Most of this equipment is utilized for highly sophisticated and complex detection in specialized fields.

Improved Components and Materials:  Scintillators (CsI, GOS, ceramic, CdWO4, and Cs(Tl)), semiconductors (s-Si, a-Se) and photodiodes (Si) will continue to rule the medical detectors industry. New developments in ceramic scintillators, YAP(Yb3+) (i.e., YAlO3), YAG, and LuAPare are fascinating, which are not only efficient but also quicker in response. Semiconductor integration technology is supporting enhanced image quality details and process speed for X-ray CT.

NanoMarkets also expects some important developments in the nanomaterials space that could lead to a new class of radiation detector. Nanoparticles' small sizes and thus larger collective surface areas translate to significantly improved detection efficiency. Metal organic frameworks (MOFs), nanophotonics, quantum dots, and nanocomposites with polymeric matrices are being studied by various research institutes with radiation detection in mind. The size of this market opportunity will depend heavily on how cost effective such novel nanomaterials can be made in the context of medical radiation detection.

Complex Software and Advanced Algorithms:  New algorithms and software for separating analysis radiation from the background noise are entering the market. This is especially relevant in medical/healthcare with the rise of 3D imaging and reconstruction; examples include dual-energy X-ray absorpitometry (DEXA) for bone densitometry and positron emission tomography (PET) image reconstruction in oncology.

What we expect to emerge from these trends are smart detector devices for healthcare where both imaging and electronics reading will be able to distinguish noise from signals.