On the 1st March 2022, Canon Medical Systems Corporation announced an agreement to acquire Nordisk Røntgen Teknik A/S (NRT), a Danish medical equipment manufacturer headquartered in Aarhus. The acquisition has been finalised following completion of approval procedures and will enable Canon Medical to strengthen its portfolio both in multi-purpose fluoroscopy and interventional gastro. As a result of the acquisition, Canon Medical will have access to European-based technology and manufacturing, as well as the opportunity to deploy advanced technology for multipurpose fluoroscopy.
Dedicated stand-alone fluoroscopy rooms to disappear
A major shift is being seen in the fluoroscopy market, with increased uptake of multi-purpose fluoroscopy systems capable of fluoroscopy, general radiography, and some interventional X-ray procedures. This trend is also reflected in fluoroscopy product launches, with the leading vendors focusing on multipurpose R&F systems, such as Fujifilm’s Persona RF PREMIUM and Siemens Healthineers’ LUMINOS Lotus Max, which were both launched at the virtual RSNA show in 2020.
The number of fluoroscopy exams conducted globally is reducing, although at a slower rate than previously seen. The associated benefits of lowered dose and higher image quality offered by MRI, CT and endoscopy, continue to drive down the number of fluoroscopy examinations performed. This reduction in fluoroscopy procedures alongside an increased focus on improving operational efficiency, is causing health providers to re-evaluate the restricted clinical usage and hence lower return on investment from dedicated fluoroscopy systems and is leading to increased consolidation of dedicated fluoroscopy rooms. With healthcare budgets being stretched globally, multi-purpose systems are becoming more popular as they enable higher usage due to the increased diversity of clinical exams that can be performed and from enhanced workflow capabilities. Furthermore, the shift of healthcare into outpatient settings further facilitates uptake of multi-purpose systems. Signify Research predicts that in the coming years, most dedicated fluoroscopy rooms in developed markets will be replaced by multi-purpose systems.
Increased competition for Siemens Healthineers
With Canon Medical acquiring NRT, competition will be heightened for Siemens Healthineers, the only other active market player in interventional gastro imaging. However, the interventional gastro market continues to be niche, with approximately 100 new global installations forecast for 2022.
An increasing number of Asian manufacturers are developing multi-purpose X-ray systems. Multi-purpose systems are portrayed as economical interventional X-ray systems due to the considerably lower cost, in comparison to an interventional suite.
As a result, to remain competitive in the fluoroscopy market, a robust portfolio of multi-purpose systems is mandatory. NRT’s high-end multi-purpose fluoroscopy systems will be complementary to Canon Medical’s existing portfolio and enable it to further strengthen its market position.
Increased scalability for NRT’s high-end multi-purpose fluoroscopy solutions
Despite its innovative and advanced fluoroscopy offerings, NRT lacks both brand recognition and scalability. Canon Medical’s global sales network will enable NRT to penetrate new markets outside of Europe, which has been its target market ahead of the acquisition. With multi-purpose fluoroscopy rooms forecast to have increased uptake primarily in developed markets, such as Western Europe, access to advanced European technology and manufacturing could strengthen Canon Medical’s market presence. The addition of NRT’s high-end fluoroscopy systems to Canon Medical’s portfolio will also open up the opportunity to provide a wider range of products serving different market segments from entry to high-end.
Canon Medical’s portfolio to be upgraded with NRT’s unique technology
Canon Medical plans to apply NRT’s expertise in advanced technology to its existing X-ray solutions. Examples of NRT’s advanced technology include its inMotion technology for automatic positioning of the detector and tube to pre-set parameters for examinations. Additionally, NRT’s Adora is an automatic, motorized digital radiographic imaging solution featuring a unique, rotating ceiling unit with two telescopic arms, one for the X-ray tube and one for the detector allowing exposures to be performed from any angle through a one-touch operation.
Another example is NRT’s Celex, a tilt-C X-ray multi-purpose system designed with wide projection, flexible and enhanced user ergonomics and patient comfort. The Celex system offers both static and DR imaging capabilities combined with unique positioning flexibility and a detachable table to provide optimal space inside the C-arm for a variety of examinations.
Canon Medical’s domestic market, Japan, is one of the largest markets for fluoroscopy globally, with the main application of fluoroscopy being the stomach barium test, a common part of the health screening process. Japanese fluoroscopy vendors are continuing to increase the clinical applications of their fluoroscopy systems to include endoscopy and colonoscopy. Lung imaging, tomosynthesis and more advanced applications are increasingly being covered in multi-purpose R/F rooms, with the primary application being gastric imaging, orthopaedics and pain management. Therefore, for Canon Medical to remain competitive amongst its Japanese peers in its domestic market, an upgrade of its existing portfolio to include NRT’s advanced technology could help bolster its market position.