New or not – does it matter with CT?
There is a massive range of CT scanners on the market now, with a very wide range of prices, and the more you want the scanner to do, the higher the purchase price on a new system as the technology costs more to develop.
One solution is to consider a second-hand scanner, but this can often be a less beneficial choice than you think. It is also worth being aware that there are different types of second-hand scanners available, and having an understanding of their relative merits is important.
Always consider why the scanner is being sold. I was once offered a 2-year-old scanner with high specifications for a very low price, with a full service history, and it seemed too good to be true… lo and behold, it was! A quick bit of research discovered that it was coming out of a busy NHS trauma centre in London – and the NHS doesn’t replace scanners unless they have worked them hard.
A CT scanner from an NHS trauma centre will have been working 24 hours a day – during the day it will be in use for at least 8-12 hours doing ‘routine’ work, and then will be used for emergencies throughout the night.
Another scanner I heard of had come from a private hospital, and had not been excessively used, but upon delivery the scanner was set up in French, albeit with a UK keyboard. The supplier was unable to work out how to get the scanner back into English and to tell the scanner that it now had a UK keyboard attached. There were also no veterinary protocols on the system, just human ones. It took a couple of days’ work to sort these issues out, and the supplier was unable to offer any training with the system as they didn’t know how to use it. This meant they were unable to run (quality assurance (QA) on the unit when installed, and it was not licenced to send to PACS (resulting in an additional cost to get the licence); as you can imagine, a cheap scanner suddenly became an expensive one!
The best way to assess how much use a scanner has had is to ask about the ‘tube hours’ – this will tell you exactly how much the X-ray tube within the scanner has been worked. If the answer is “a lot” it stands to reason that the rest of the system has also been worked hard! Chronological age is not of much interest here.
A new tube for a CT scanner will cost £30,000 - £60,000 to replace, depending upon the tube required, and if you are offered the whole scanner for less than this price you should consider if a new tube will be needed in the near future.
Another thing to consider is that second-hand scanners may be using quite old technology, so depending upon what you are looking to do with the system you may find it can’t actually perform the scans that you want. In particular, if you are looking to perform cardiac scans this may be a real issue.
As some of the major advances in CT scanning over the last few years have been rotation speed, resolution and computing power, some older scanners being sold may not have sufficient ability to cool the X-ray tube while scanning, as whenever we undertake veterinary scanning we are often pushing the systems to their design limits, and it is easy to overheat the X-ray tube. This can result in you having to wait between scans, or even simply not being able to undertake certain scans that you want – for example high resolution pelvis images pre- and post-contrast.
Computing power doesn’t just relate to the acquisition of your scan, but also the post-processing – will the system be able to do the 3D reconstructions that you want?
Most manufacturers offer reconditioned scanners and these are a great option; they will cost more than a second-hand scanner from an independent re-seller, but there is a reason for this.
A manufacturer-reconditioned scanner will have had a full service and refurbishment, with any worn parts being replaced with official parts. In addition, a guarantee on the tube with also be given along with one year’s warranty and full access to the manufacturers service scheme (with genuine parts).
Another cost to consider is servicing: CT machines have many moving parts and do really need to be serviced regularly to ensure you get the best from them. As machines age it becomes harder to get parts, and there will come a time when if your tube goes you may not be able to replace it.
If you want more advice on new or reconditioned GE or Epica CT scanners, please just ask.
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