U.S. C-arms Market Size, Share & COVID-19 Impact Analysis, By Type (Fixed C-arms, Mobile C-arms (Full-Size c-arms, Mini C-arms), By Application (Orthopedics and Trauma, Cardiology, Neurology, Gastroenterology, Oncology, and Others), By Detector (Flat Panel Detector, and Image Intensifier), By End User (Hospitals, Ambulatory Surgical Center, and Specialty Clin-ics), 2020-2027

The U.S c-arms market size was USD 814.0 million in 2019 and is projected to reach USD 1,146.1 million by 2027, exhibiting a CAGR of 4.4% during the forecast period.

A c-arm is an imaging scanner intensifier with radiographic abilities used largely for fluoroscopic intraoperative imaging during orthopedic, surgical, and emergency care procedures. These devices provide high-resolution X-ray images in real-time, therefore allowing the doctors to monitor progress and instantly make any corrections. There are several advantages of diagnostic imaging due to the development of C-arms to digital flat-panel detectors (FPDs) from the traditional X-ray image intensifier technology. For example, OEC Elite CFD mobile C-arms (GE Healthcare) are used in several healthcare settings by surgeons and by interventionists. The CMOS flat detector assists in the generation of remarkable image quality at a lower dose, using unique software features such as Live Zoom. The enhanced positioning and ease of use are also contributing to increased efficiency by augmenting the clinical workflow.

Factors such as custom-made imaging solutions for a varied variety of clinical applications and superior flexibility in the choice of navigation system are responsible for the fastest growth of the c-arms market in the forecast period. Moreover, mobile C-arms have better maneuverability & precision and deliver an instant hard copy of images, when required, Thus, expediting the growth of the total C-arms market.

COVID-19 Lockdown Measures to Have a Negative Impact on Market

The recent Covid-19 pandemic has had a drastic impact on the market owing to stringent measures taken to curb the spread of the disease. This has either halted or postponed surgical procedures. Moreover, disruption in the supply chain, sales of the manufacturers have declined. However, the government has allowed the conductance of emergency procedures for orthopedics, cardiology, etc.

Also, the number of patient visits for diagnosis has drastically reduced due to the coronavirus outbreak. Additionally, the adoption of systems by the end-users has also declined, decreasing the sales volume of the companies. This impact is likely to continue the FQ 2020 and slower in the latter half of the year.

LATEST TRENDS

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Incorporation of Artificial Intelligence in Radiology is a Current Trend

Artificial Intelligence (AI) has been rapidly progressing in medicine, especially in the field of radiology. AI optimizes workflow, facilitates quantitative radiology, and assists in discovering genomic markers. The new age of imaging systems with AI noticeably enhanced diagnosis capability and imaging quality. By enhancing smaller amounts of data, AI accelerates imaging time, improved resolution, and enables dose reduction. For example, in September 2019 researchers from Intermountain Healthcare and Stanford University fabricated an artificial intelligence system, called the CheXpert system that can detect critical findings in chest x-rays as fast as ten seconds. CheXpert, is a computerized chest x-ray interpretation model that leverages AI to review x-ray images. This model can determine what is and is not pneumonia on an x-ray.

DRIVING FACTORS

Advantages of FPDs over Image Intensifiers to Favor Growth

There has been a preferential shift in diagnostics imaging of C-arms-from the traditional X-ray image intensifier technology to digital flat-panel detectors (FPDs). FPDs have several advantages, such as reduced radiation dose and compact size. It also has the ability to produce high-quality digital images consistently, whereas the quality deteriorates in the case of traditional image intensifiers due to aging. For example, GE Healthcare OEC Elite CFD mobile C-arms with CMOS flat-panel detectors (CFD) is being used in a variety of clinical settings by an interventional cardiology endovascular surgeon and by an interventionist specializing in pain management. Furthermore, the growth is attributed to the increasing demand for interventional radiology procedures and the rising orthopedic surgeries due to the aging population and sports injuries.

Shift from Analog to Digital Radiography & Remarkable Reimbursement to Boost Growth

The preferential shift towards digital radiography imaging due to the introduction of digital flat panel detectors, and favorable reimbursement policies for healthcare settings is propelling the growth of the market. For instance, in January 2017, CMS imposed a 20.0% reimbursement penalty for X-ray procedures performed on film-based x-ray systems. From January 2018, end-users using CR-based systems suffered a 7.0% penalty to the Medicare technical component. That reduction is expected to increase to 10.0% in January 2023.

The Consolidated Appropriations Act of 2016 states that Medicare reimbursements will be reduced by 20 percent per year for providers submitting claims for analog X-ray studies done from 2016. From 2018 through 2022, payments for imaging tests performed on CR equipment will be reduced by 7 percent, with a 10 percent reduction beginning in 2023. Thus, the shift from analog to digital coupled with favorable reimbursement policies for digital radiography system based medical imaging will fuel the demand for the c-arms integrated with digital radiography technique.

RESTRAINING FACTORS

High Cost of Instruments to Hinder Market Growth

Mobile C-arms have a price range of around $200,000 due to its advanced features and functionalities. Advanced mobile C-arms, together with generators up to 20kW enables the penetration of dense anatomies. The most expensive C-arms are manufactured by GE Healthcare’s OEM 9900 Elite and Ziehm Imaging’s Vision RFD which come with large image displays to allow precise evaluation of images.

Besides the high cost of equipment, there are other direct expenses for printers and DICOM boxes which increases the total cost of ownership. Due to this, the usage of the equipment is extended beyond its average life. Furthermore, the current healthcare economic climate forces financial administrators to control the purchasing of medical imaging equipment due to its limited return-on-investment policies and versatility of procedures paramount in purchasing decisions. The aforementioned factors above are likely to cause hindrance to market growth in the forecast period.

SEGMENTATION

By Type Analysis

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Mobile C-arms Segment to Dominate Owing to the Portability of the Product

Based on type, the market is segmented into fixed and mobile. The mobile c-arms segment held the largest share in 2019, and likely to see the fastest growth over the forecast period owing to their varied range of clinical applications and greater flexibility in the choice of the navigation system. Mobile C-arms are also expected to witness the fastest CAGR over the forecast period owing to their tailored imaging solutions for a varied range of clinical applications and greater flexibility in the selection of navigation systems. Moreover, they provide an ideal angle for high-quality images and permit easy movement & positioning (motorized axes), along with keeping the patient comfortable.

Mobile c-arms are further segmented into full-size c-arms and mini c-arms. Several mini c-arms are precisely projected for extremity imaging and have a lower footprint as compared to their full-size counterparts, along with improved mobility. For example, OrthoScan Inc. FD Pulse is the first mini C-Arm equipped with pulsed fluoroscopy which helps in powerful imaging for various applications. Full-size C-arms segment would dominate over the mobile C-arms segment owing to factors such as large dual monitors, powerful generators, and other operational benefits, which are not offered by mini c-arms.

By Application Analysis

Cardiology Segment to Lead Backed by Rising Number of Cardiac Surgeries

Based on the application, the market is segmented into orthopedics and trauma, cardiology, neurology, gastroenterology, oncology, and others. Among these, the cardiology segment held the largest share in 2019. The growth of this segment is propelled by factors such as maneuverability of C-arm units for capturing accurate images from multiple positions, operability, good image quality, flexibility, and efficiency. Also, according to the CDC, cardiovascular disease (CVD) remains the leading cause of death globally. This factor will contribute to the growing number of surgeries leading to the adoption of C-arms for cardiovascular application.

The orthopedics and trauma segment is expected to witness increased growth during the forecast period. The number of orthopedic surgeries is expected to upsurge in the coming years owing to aging demographics and growing obesity rates globally. To support this, Siemens Healthineers products such as Cios Alpha, Cios Fusion, and Cios Select have prominently contributed and set standards for orthopedic surgeries.

By Detector Analysis

Demand for Image Intensifier based C-arms to Increase Due to their High-resolution Image Production

Based on detectors, the market is segmented into image intensifiers and flat-panel detectors. Among these, the image intensifiers segment accounted for a dominant share in 2019 owing to a large installed base globally. In addition to this, low acquisition and maintenance cost as compared to its flat-panel counterparts have attracted end-users towards image intensifiers based C-arms.

Flat-panel detectors offer several advantages over conventional image intensifiers. These include high-quality image acquisition, reduced radiation exposure (by 90%) as compared to analog and CR-based systems, and easy image interpretation. For example, an aging installed base of x-ray systems has forced healthcare settings to replace the current systems with new and advanced x-ray systems. The majority of these systems are being offered with digital radiography detectors such as amorphous silicon flat-panel detectors thus creating a huge potential for the FPD market.

By End User Analysis

Increasing Occurrence of Interventional Procedures to Aid Growth of Hospitals Segment

Based on end-users, the market is segmented into hospitals, ambulatory surgical centers, and specialty clinics. The increasing interventional procedures have led to an increase in the demand for medical imaging. Therefore, there is a growing need for mobile c-arms in hospitals to accelerate diagnostic procedures. Furthermore, the growing demand for the new shipment of c-arms by healthcare facilities in emerging countries for various applications is impelling the market growth.

The ambulatory surgical centers segment is projected to grow at the highest CAGR during the forecast period. This is attributable to the flexibility and mobility of c-arm devices that allows medical imaging professionals to provide essential services in ambulatory surgical centers. Also, growing ambulatory surgery centers in developed countries is anticipated to increase the sales of mobile c-arms systems in the forecasted timeframe.

KEY INDUSTRY PLAYERS

Robust Portfolio and Strong Brand Presence of Major Players to Result in a Consolidated Market

The market is dominated by 3 major players, which includes GE Electric Company, Siemens AG Healthineers, and Koninklijke Philips N.V. These companies together accounted for over 80% of share in the U.S. market in 2019. For instance, in December 2018, GE Healthcare announced the commercial release of OEC Touch for OEC Elite CFD features a new control panel located right on the C-arm. The new control panel, OEC Touch, is intended to eradicate the need to move to a separate workstation and decrease disruption during surgery. Several companies in the market are continuously engaged in the development of novel diagnostic technology and strengthening their distribution channel across the globe to establish their footprints in emerging regions.

LIST OF KEY PLAYERS PROFILED IN THIS REPORT:

• GE Healthcare (Chicago, U.S)


• Koninklijke Philips N.V. (Amsterdam, Netherlands)


• Siemens Healthineers AG (Munich, Germany)


• Canon Medical Systems Corporation (Tochigi, Japan)


• ATON GmbH (Ziehm Imaging, Inc. and OrthoScan, Inc.) (Bayern, Germany)


• Shimadzu Corporation (Kyoto, Japan)


• Hologic, Inc. (Massachusetts, U.S)


• Eurocolumbus s.r.l. (Milano, Italy)


• Other Players

KEY INDUSTRY DEVELOPMENTS:

• April 2021- Carestream Health entered into a partnership with Ziehm Imaging GmbH to include Ziehm Vision RFD C-arm in its product line with an aim to enhance mobile and fluoroscopic product offerings in vascular, cardiac, spine ortho-trauma and pain management.


• March 2021- GE Healthcare, announced the 510(k) clearance from the U.S. FDA for OEC 3D C-arm that can perform 3D and 2D imaging with an aim to obtain precise volumetric images for spine and orthopedic procedures.


• January 2021- Siemens Healthineers announced the U.S. FDA clearance of Cios Flow, a mobile C-arm, used in orthopedics, trauma surgery, spinal surgery, vascular surgery, and pain therapy with a view to increase the product line as well as to make the product cost effective by increasing the usage in multiple surgeries.

REPORT COVERAGE

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The report provides a detailed analysis of the market and focuses on key aspects such as leading companies, product types, and leading modalities types. Besides this, the report offers insights into the market, current trends, and highlights key industry developments. In addition to the aforementioned factors, the report encompasses several factors that have contributed to the growth of the market over recent years.

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