VIENNA, Austria — What a difference a year makes.

At last year's European Congress of Radiology, Agfa Healthcare (Mortsel, Belgium) was on the ropes and the buzz among sales reps and executives in the corridors was that this division, which accounts for 40% of sales for the larger Agfa-Gevaert Group would be sold.

Reporting a 12% loss in sales for the division, and hammered on the Euronext-Brussels stock exchange, the holding company confirmed it would carve out the €1.2 billion ($1.5 billion) healthcare division, but with great embarrassment withdrew the proposition several months later when no one stepped forward to save the struggling business.

The stock price plummeted from €5 ($6.25) to below €1.50 ($1.90) and facing the larger global financial crisis and an uncertain future, the company's board refused to make any further previsions (Medical Device Daily, Sept. 22, 2008 and March 11, 2009).

It would have been a good moment to buy the stock.

“We went above six euros today,“ beamed Eric Maurincomme, head of strategy and marketing for Agfa HealthCare patrolling the exhibition space at ECR 2010 with a certain swagger.

“We are growing market share across the board with a renewed portfolio of products less than 18 months old, and we are growing our sales in consumables from contrast media to drapes and gowns,“ he said to explain the buzz among stock analysts encouraging a 'buy' position.

“Since January 2009 we have signed 50 new agreements for the IMPAX picture archiving and communication system (PACS) some of them landmark deals such as the Cleveland Clinic and the U.S. Air Force data center,“ he continued.

“Altogether we reported 100 net new site sales in 2009, he said.

Dirk Debusscher, VP Imaging at Agfa, jumped into the conversation to add, “we also are very active on the low end of the market and a landmark here is the $500 million deal we signed with China covering four years that took us more than two years to negotiate.“

According to Maurincomme the final figures for 2009 that are due to be reported next week will show the Healthcare division lost 3% to 4% in sales, “but we doubled our profitability.“

Defending CR with next generation system

A major revenue stream for Agfa is the sale of phosphorous plates for conventional computed radiology (CR) x-ray, which is threatened by the shift to digital radiography (DR) detector plates.

An executive with Carestream Health (Rochester, New York), which is an aggressive DR vendor, estimates the worldwide market for radiology stands at $3.8 billion today and that CR continues to hold about $2.1 billion, or a 55% market share.

He added that the conversion to DR has been slower in Europe where CR holds a significantly higher market share.

The New Agfa DirectriX (DX) line is designed to defend this market share, by bridging the gap between CR and DR, and even build a preference for staying with the quality of images acquired with phosphorous-packed plates over pixels.

At ECR 2010 Agfa introduced the DX-G, for general radiology applications, and the DX-M for mammography.

Both the plates, and the digitizer that converts the image acquired by the plate to numeric format, have been re-engineered for what the company is promoting as a next-generation CR.

The DX needle-based crystalline detector plate uses a crystal phosphor that allows higher packing density and layer thickness than is offered by powder phosphor when used in a binding material.

As a result, the light spread is reduced with the crystal phosphor and sharpness of the image is increased.

The DX line also uses the ScanHead, an accelerated line-to-line scanner providing preview images faster and a high throughput of up to 130 cassettes per hour, which reduces waiting times.

A 2008 study by J. M. Fernandez, et al., compared image quality for similar exposure conditions between two flat-panel DR systems and the needle-based crystalline CR, assessing contrast quality and concluded the DX system matched one DR system and was superior to he other while providing image quality superior to a conventional CR system.

The go-to-market benefits of the new DX CR solution is enhanced image quality that the company says meets or exceeds flat-panel DR detectors, and at a significantly lower cost.

“DR has an advantage for routine examinations, but CR continues to be valued for imaging extremities and special cases,“ said Maurincomme, explaining that the needle crystal plates are even better producing resolutions at 50 microns at a lower dose, where DR, “at its best is 78 microns and most often at 100 microns.“

“High end CR is proving to be the answer,“ he said.

Both new DX systems for the new needle-crystal detector plates can also handle conventional phosphor plates, leveraging a radiography department's existing investment.

Debusscher said the Agfa strategy is to “evolve customers toward DR and not force them to make a decision that is either all-DR or all- CR.

“In 90% of the cases where we have sold digital radiology, it has been to customers integrating the new units with their existing computed radiology scanners,“ he said.

“Where a hospital may have seven radiology exam rooms, they might only have the budget, or the interest, to convert two of these rooms to DR,“ he said.

“We show them that they can keep the same familiar user interface, the same imaging platform and with little new training can upgrade to new capabilities, he said, adding, “that is proving to be a strong proposition.“.

A less straight-forward tactic on Agfa's part is promoting the new system using the “D“ label when there is nothing digital in the technology, helping to further confusion among radiologists between true digital systems and conventional CR.

Other promoted benefits for the new DX line include a user-friendly drop-and-go buffer that can handle a mix of five cassettes of different sizes, facilitating a smoother and more productive workflow.

With a smaller footprint, the DX units can be placed in any available space and used as a centralized or decentralized digitizer in the radiography department, supporting a broad range of applications.

The DX line is supported by the Agfa NX workstation and the MUSICA2 automated image processing software.