2012 PET IMAGING MARKET SUMMARY REPORT. Table of Contents

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1 1400 EAST TOUHY AVE, SUITE 250 DES PLAINES, IL Phone: Fax: PET IMAGING MARKET SUMMARY REPORT Table of Contents I. Objectives... I-1 II. Executive Summary... II-1 III. Methodology... III-1 IV. Findings...IV-1 A. PET Study Volume...IV-1 B. Installed Base of PET/CT and PET Scanners...IV-34 C. Purchase Plans for PET Imaging Equipment and Market Scenarios...IV-55 D. Cyclotron Installed Base and Purchase Plans at End-User PET Imaging Sites... IV-71 E. Radiopharmaceutical Utilization and Budgets...IV-73 F. PET Imaging Site Operations Characteristics...IV-95

2 2012 PET IMAGING MARKET SUMMARY REPORT Exhibits A. PET Study Volume 1. Distribution of PET Imaging Sites and Patient Studies, All Sites, by Current PET Capability, IV-1 2. Total Estimated Clinical PET Patient Studies, by Current PET Capability, IV-2 3. Total PET Imaging Sites, by Current PET Capability, by Census Year, 2001 to IV-2 4. Distribution of PET Imaging Sites and Patient Studies, by Site Type, IV-3 5. Total Estimated Clinical PET Patient Studies, by Site Type, IV-3 6. Total PET Imaging Sites, by Site Type, by Census Year, 2001 to IV-4 7. Distribution of PET Imaging Sites, by Current PET Capability and Site Type, as of 2012 PET Census Survey...IV-4 8. Distribution of PET Capability of PET Imaging Sites, by Site Type, as of 2012 PET Census Survey.IV-5 9. Percent of Short-Term General Hospitals Performing PET Imaging, by Current PET Capability, as of 2012 PET Census Survey...IV Average Annual Clinical PET Patient Studies per Site, by Current PET Capability and Site Type, IV Average Annual Clinical PET Patient Studies per Site, by Current PET Capability, IV Average Annual Clinical PET Patient Studies per Site, by Site Type, IV Distribution of PET Imaging Sites by Patient Study Volume Ranges, by Current PET Capability, IV Distribution of PET Imaging Sites by Patient Study Volume Ranges, by Site Type, IV Distribution of PET-Only and PET/CT Patient Studies Performed on PET/CT or PET Scanners, by Current PET Capability, IV Percent of PET-Only and PET/CT Patient Studies Performed on PET/CT or PET Scanners, by Current PET Capability, IV Mix of Oncology, Cardiology and Neurology Clinical Applications for PET/CT and PET Patient Studies, IV Total Estimated PET/CT and PET Patient Studies, by Clinical Application, IV Clinical PET/CT and PET Patient Studies Application Mix, by Site Type, IV Percent of PET Imaging Sites Performing Clinical Application Types, and Mean Annual Patient Studies per Site Performing, IV Percent of PET Imaging Sites Performing Oncology Applications, and Mean Annual Patient Studies per Site Performing, by Site Type, IV Percent of PET Imaging Sites Performing Cardiology Applications, and Mean Annual Patient Studies per Site Performing, by Site Type, IV Percent of PET Imaging Sites Performing Neurology Applications, and Mean Annual Patient Studies per Site Performing, by Site Type, IV Estimates of Clinical Applications Mix, by Current PET Capability, IV Estimates of Percent & Number of Sites Performing PET Imaging Patient Studies, and Average Studies per Site Performing, by Clinical Application, IV Distribution of PET Imaging Oncology Patient Studies, by Cancer Procedure Type, IV Distribution of PET Imaging Oncology Patient Studies, by Respiratory Cancer Study Type, IV Total PET Imaging Oncology Patient Study Volume, by Cancer Procedure Type, IV PET Oncology Patient Study Volume for Respiratory Applications, IV Percent of Sites Performing PET Oncology Patient Studies, and Mean Annual Patient Studies per Site Performing, by Cancer Procedure Type, IV Patient Management Stages that PET Oncology Studies are Used for, by Current PET Capability, IV Patient Management Stages that PET Oncology Studies are Used for, by Site Type, IV-18

3 33. Percent of Sites Using PET Oncology Studies for Patient Management Stages, by Current PET Capability, IV Percent of Sites Using PET Oncology Studies for Patient Management Stages, by Site Type, 2011.IV Estimates of PET Oncology Patient Studies, by Current PET Capability, IV Estimates of Percent/Number of Sites Performing PET Oncology Procedures, and Average Patient Studies per Site Performing, by Current PET Capability, IV Types of PET Neurology Studies, by Current PET Capability, IV Types of PET Neurology Studies, by Site Type, IV Percent of Sites Performing PET Neurology Studies, and Mean Annual Patient Studies per Site Performing, by Neurology Study Type, IV Percentage Mix of PET Patient Studies Performed, by Current PET Capability, IV Percentage Mix of Patient Studies Performed on Fixed vs. Mobile PET/CT and PET Scanners, by Site Type, IV PET Inpatient vs. Outpatient Mix, All Sites, IV PET Inpatient vs. Outpatient Mix, by Site Type, IV Total Estimated Clinical vs. Research PET Patient Studies, IV Percentage of Sites Performing Research vs. Clinical PET Patient Studies, by Current PET Capability, IV Percent of Fixed vs. Mobile PET/CT Sites Performing Diagnostic CT-Only Scans with No Associated PET Scans, as of 2012 PET Census Survey...IV Percent of Fixed & Mobile PET/CT Sites Performing Diagnostic CT-Only Scans with No Associated PET Scans, by Site Type, as of 2012 PET Census Survey...IV Percent of Fixed PET/CT Sites Performing Diagnostic CT-Only Scans with No Associated PET Scans, by Census Year, IV Average Number of CT-Only and PET Studies per Site, at Sites Performing CT-Only Diagnostic Studies on their Fixed or Mobile PET/CT Scanner, IV Functionality of CT Scans Performed on PET/CT Scanners, by Current PET/CT Capability, 2011.IV Whether Department Currently Performs or Plans to Perform Specific Specialized Procedures with a PET or PET/CT Scanner, as of 2012 PET Census Survey...IV Whether Department Currently Performs or Plans to Perform PET Simulation for Radiation Therapy Treatment Planning, by Site Type, as of 2012 PET Census Survey...IV Whether Department Currently Performs or Plans to Perform PET Myocardial Perfusion Studies, by Site Type, as of 2012 PET Census Survey...IV Whether Department Currently Performs or Plans to Perform Cardiovascular CT Studies with a PET or PET/CT Scanner, by Site Type, as of 2012 PET Census Survey...IV Whether Department Currently Performs or Plans to Perform New PET Technologies, as of 2012 PET Census Survey...IV Whether Department Currently Performs or Plans to Use Neuro Imaging Agents to Detect Beta-Amyloid Plaque for Alzheimer s Disease, by Site Type, as of 2012 PET Census Survey...IV Whether Department Currently Performs or Plans to Perform PEM (Positron Emission Mammography) Studies, by Site Type, as of 2012 PET Census Survey...IV Whether Department Currently Performs or Plans to Perform PET/MR, by Site Type, as of 2012 PET Census Survey...IV-33 B. Installed Base of PET/CT and PET Scanners 1. Distribution of Fixed PET/CT vs. PET Scanners in Hospital vs. Non-Hospital Sites, as of 2012 PET Census Survey...IV Distribution of Fixed PET/CT and PET Scanners, by Census Year, IV Distribution of Fixed PET/CT and PET Scanners, by Hospital vs. Non-Hospital Location, by Census Year, IV Distribution of Hospital and Non-Hospital Sites with Fixed PET/CT or PET Scanners, by Census Year, IV Site Type Mix of Sites with Mobile vs. Fixed PET/CT & PET Scanners, by Site Type, as of 2012 PET Census Survey...IV-36

4 6. Distribution of Mobile vs. Fixed PET/CT and PET Sites, by Site Type, as of 2012 PET Census Survey...IV Mobile vs. Fixed PET/CT or PET: Sites and Units, as of 2012 PET Census Survey...IV Distribution of Fixed PET/CT and PET Scanners, by Site Type, as of 2012 PET Census Survey...IV Distribution of Sites, by Number of Fixed PET/CT or PET Scanners Installed, by Site Type, as of 2012 PET Census Survey...IV Percent Distribution of Fixed PET/CT & PET Installed Base, by Vendor, as of 2012 PET Census Survey...IV Unit Distribution of Fixed PET/CT and PET Installed Base, by Vendor, by Census Year, 2001 to IV Fixed PET/CT & PET Installed Base Share, by Vendor, by Census Year, from 2001 to IV Fixed PET/CT & PET Installed Base, by Vendor, by Site Type, as of 2012 PET Census Survey...IV Fixed PET/CT & PET Installed Base, by Year of Installation, as of 2012 PET Census Survey...IV Distribution of Fixed PET/CT & PET Installed Base, by Year of Installation, by Site Type, as of 2012 PET Census Survey...IV Adoption of Fixed PET/CT vs. PET Scanners, by Year of Installation, as of 2012 PET Census Survey...IV Percent Distribution of Fixed PET/CT Installed Base, by Vendor, as of 2012 PET Census Survey...IV Unit Distribution of Fixed PET/CT Installed Base, by Vendor, by Census Year, 2003 to IV Fixed PET/CT Installed Base Share, by Vendor, by Census Year, 2003 to IV Fixed PET/CT Installed Base Share, by Vendor, by Site Type, as of 2012 PET Census Survey...IV Fixed PET/CT Installed Base, by Year of Installation, as of 2012 PET Census Survey...IV Distribution of Fixed PET/CT Installed Base, by Year of Installation, by Site Type, as of 2012 PET Census Survey...IV Percent Distribution of PET/CT Installed Base, by Number of CT Slices, as of 2012 PET Census Survey...IV Distribution of PET/CT Scanner Installed Base, by Number of CT Slices, by Site Type, as of 2012 PET Census Survey...IV PET/CT Installed Base Market Share, by Number of CT Slices, as of 2012 PET Census Survey...IV Percent of PET/CT Installations, by Number of CT Slices, by Year of Installation, as of 2012 PET Census Survey...IV Distribution of PET/CT Installed Base, by Crystal Type, as of 2012 PET Census Survey...IV Distribution of Installed Base of PET/CT Scanners, by Crystal Type, by Site Type, as of 2012 PET Census Survey...IV PET/CT Installed Base Market Share, by Crystal Type, as of 2012 PET Census Survey...IV Percent of PET/CT Installations, by Crystal Type, by Year of Installation, as of 2012 PET Census Survey...IV Bore Size of Installed PET/CT Scanners, as of 2012 PET Census Survey...IV Distribution of Installed Base of PET/CT Scanners, by Bore Size, by Site Type, as of 2012 PET Census Survey...IV PET/CT Installed Base Market Share, by Bore Size, as of 2012 PET Census Survey...IV Percent of PET/CT Installations, by Bore Size, by Year of Installation, as of 2012 PET Census Survey...IV Percent Distribution of Fixed PET Installed Base, by Vendor, as of 2012 PET Census Survey...IV Unit Distribution of Fixed PET Installed Base, by Vendor, by Census Year, 2001 to IV Fixed PET Installed Base Share, by Vendor, by Site Type, as of 2012 PET Census Survey...IV Fixed PET Installed Base, by Year of Installation, as of 2012 PET Census Survey...IV Distribution of Fixed PET Installed Base, by Year of Installation, by Site Type, as of 2012 PET Census Survey...IV Distribution of Fixed PET Installed Base, by Crystal Type, as of 2012 PET Census Survey...IV Distribution of Financing Methods for PET/CT & PET Installed Base, by Site Type, as of 2012 PET Census Survey...IV Distribution of Sources for PET/CT & PET Service Support, by Site Type, as of 2012 PET Census Survey...IV-54

5 C. Purchase Plans for PET Imaging Equipment and Market Scenarios 1. PET Site Plans for Purchasing PET Imaging Equipment Over the Next Three Years, as of 2012 PET Census Survey...IV PET Site Plans for Purchasing PET Imaging Equipment Over the Next Three Years, by Current PET Capability, as of 2012 PET Census Survey...IV PET Site Plans for Purchasing PET Imaging Equipment Over the Next Three Years, by Site Type, as of 2012 PET Census Survey...IV Planned Purchases of PET/CT, PET/MR vs. PET Scanners, by Site Type, as of 2012 PET Census Survey...IV Purchase Plans of Sites Currently Using Mobile PET or PET/CT, by Site Type, as of 2012 PET Census Survey...IV Planned Purchases for First Buyer, Replacement vs. Additional PET Imaging Units, by Current PET Capability, as of 2012 PET Census Survey...IV Current PET Replacement Cycle, Based on 2012 PET Census Survey Responses...IV Estimated Raw Replacement Unit Demand from PET Installed Base (as of 2012 Census Survey), Based on Current PET Replacement Cycle, IV Scenario I: Raw PET Replacement Demand, Estimated PET Imaging Unit Market Projections, IV Scenario II: Reduced Purchase Intent for First Buyer/Replacement/Additional PET Imaging Units, Estimated PET Imaging Unit Market Projections, IV Distribution of Planned PET/CT Purchases, by Number of CT Slices, as of 2012 PET Census Survey...IV Planned Purchases of PET/CT Scanners, by Number of CT Slices, by Current PET Capability, as of 2012 PET Census Survey...IV Planned Purchases of PET/CT Scanners, by Number of CT Slices, by Site Type, as of 2012 PET Census Survey...IV Distribution of Planned PET/CT Purchases, by Bore Size, as of 2012 PET Census Survey...IV Planned Purchases of PET/CT Scanners, by Bore Size, by Current PET Capability, as of 2012 PET Census Survey...IV Planned Purchases of PET/CT Scanners, by Bore Size, by Site Type, as of 2012 PET Census Survey...IV Distribution of Planned PET/CT Purchases, by Crystal Type, as of 2012 PET Census Survey...IV Distribution of Intended Financing Methods for Next PET Acquisition, by Site Type, as of 2012 PET Census Survey...IV Percent Distribution of Sites Mentioning Vendors Considered for Future PET Imaging Unit Purchases, as of 2012 PET Census Survey...IV Brand Loyalty: PET Technology Vendor Being Considered by Current PET Imaging Sites, as of 2012 PET Census Survey...IV Distribution of 2012 PET Capital Equipment Budgets, as of 2012 PET Census Survey...IV PET Capital Equipment Budget Trend, by Budget Year, IV Distribution of 2012 PET Capital Equipment Budgets, by Current PET Capability, as of 2012 PET Census Survey...IV Average 2012 PET Capital Equipment Budget per Site Having Budgets >$0, by Current PET Capability, as of 2012 PET Census Survey...IV Distribution of 2012 PET Capital Equipment Budgets, by Site Type, as of 2012 PET Census Survey...IV Average 2012 PET Capital Equipment Budget per Site Having Budgets >$0, by Site Type, as of 2012 PET Census Survey...IV Distribution of PET Capital Equipment Budgets, as of 2012 PET Census Survey...IV Buying Group Influence on PET Equipment Purchases, All Sites, as of 2012 PET Census Survey...IV Buying Group Influence on PET Equipment Purchases, Hospital & Non-Hospital Sites, as of 2012 PET Census Survey...IV-70

6 D. Cyclotron Installed Base and Purchase Plans at End-User PET Imaging Sites 1. Cyclotron Installed Base at End-User PET Imaging Sites and Planned Purchases, by Site Type, as of 2012 PET Census Survey...IV Cyclotron Installed Base at End-User PET Imaging Sites, by Year of Installation, as of 2012 PET Census Survey...IV Percent Distribution of Cyclotron Installed Base at End-User PET Imaging Sites, by Vendor, as of 2012 PET Census Survey...IV-72 E. Radiopharmaceutical Utilization and Budgets 1. Total Estimated Clinical PET/CT and PET Patient Studies, by Source of Radiopharmaceuticals, IV Radiopharmaceutical Sources for PET/CT and PET Sites, by Current PET Capability, IV Distribution of Clinical PET/CT and PET Patient Studies, by Source of Radiopharmaceuticals, by Site Type, IV Radiopharmaceutical Sources for PET/CT and PET Sites, by Site Type, IV Average Clinical PET/CT and PET Patient Studies per Site, by Source of Radiopharmaceuticals, by Current PET Capability, IV Average Clinical PET/CT and PET Patient Studies per Site, by Source of Radiopharmaceuticals, by Site Type, IV Average Clinical PET/CT and PET Patient Studies per Site, by Source of Radiopharmaceuticals, All Sites, IV Average Clinical PET/CT and PET Patient Studies per Site, by Source of Radiopharmaceuticals, for Fixed PET/CT and PET Sites, IV Distribution of Clinical PET/CT and PET Patient Studies, by Radiopharmaceutical Used, IV Percent of Sites Using Radiopharmaceuticals and Mean Annual Patient Studies per Site Using that Agent, IV Average Clinical PET/CT and PET Patient Studies per Site Using F 18 DG, by Current PET Capability, IV Whether Department Currently Performs PET Myocardial Perfusion Studies, by Current PET Capability, as of 2012 PET Census Survey...IV Whether Department Currently Performs PET Myocardial Perfusion Studies, by Site Type, as of 2012 PET Census Survey...IV Distribution of PET Imaging Sites Performing PET Myocardial Perfusion Studies, and Number of Patient Studies Performed, by Current PET Capability, IV Percent of Sites Performing PET Myocardial Perfusion Studies and Mean Annual Patient Studies per Site, by Current PET Capability, IV Percent of Sites Performing PET Myocardial Perfusion Studies and Mean Annual Patient Studies per Site, by Site Type, IV Distribution of PET Myocardial Perfusion Patient Studies, by Whether Stressed or Not Stressed with a Pharmacological Stress Agent, by Current PET Capability, IV Percent Distribution of PET Pharmacological Stress Agents Used in Myocardial Perfusion Patient Studies, IV Average Price per Dose of F 18 DG Used in the Last Three Months for PET Patient Studies, by PET Capability, as of 2012 PET Census Survey...IV Average Price per Dose of F 18 DG Used in the Last Three Months for PET Patient Studies, by Site Type, as of 2012 PET Census Survey...IV Whether F 18 DG Price per Dose Includes Shipping, as of 2012 PET Census Survey...IV Percent Distribution of Millicuries of F 18 DG Injected per Patient, by Site Type, as of 2012 PET Census Survey...IV Distribution of 2011 PET Radiopharmaceutical Budgets, for PET Imaging Sites Using Outside Suppliers...IV PET Radiopharmaceutical Budget Trend, IV Distribution of PET Radiopharmaceutical Budgets, by Current PET Capability, IV Distribution of PET Radiopharmaceutical Budgets, by Site Type, IV-85

7 27. Average PET Radiopharmaceutical Expenditures per Site, by Current PET Capability, IV Average PET Radiopharmaceutical Expenditures per Site, by Site Type, IV Average PET Radiopharmaceutical Expenditures per Clinical PET Patient Study, by Current PET Capability, IV Average PET Radiopharmaceutical Expenditures per Clinical PET Patient Study, by Site Type, IV PET Radiopharmaceutical Expenditures in PET/CT and PET Sites, by Current PET Capability, IV PET Radiopharmaceutical Expenditures, in PET/CT and PET Sites, by Site Type, IV Radiopharmaceutical Expenditures in PET/CT and PET Sites, by Current PET Capability, IV Distribution of PET Radiopharmaceutical Budgets, as of 2012 PET Census Survey...IV Market Share of PET Radiopharmaceutical Suppliers, Based on PET Radiopharmaceutical Expenditures, IV Market Share of PET Radiopharmaceutical Suppliers, Based on PET Radiopharmaceutical Expenditures, IV Market Share of PET Radiopharmaceutical Suppliers, Based on PET Radiopharmaceutical Expenditures, by Current PET Capability, IV Market Share of PET Radiopharmaceutical Suppliers, Based on PET Radiopharmaceutical Expenditures, by Site Type, IV Percent of PET Sites Mentioning Radiopharmaceutical Suppliers Used, IV Estimated Expenditures for PET Radiopharmaceuticals, by Supplier and Current PET Capability, IV Buying Group Influence on PET Radiopharmaceutical Purchases, All Sites, as of 2012 PET Census Survey...IV Buying Group Influence on PET Radiopharmaceutical Purchases, Hospital & Non-Hospital Sites, as of 2012 PET Census Survey...IV-94 F. PET Imaging Site Operations Characteristics 1. Department Operating PET Imaging Equipment, by Site Type, as of 2012 PET Census Survey...IV Department Operating PET Imaging Equipment, by Current PET Capability, as of 2012 PET Census Survey...IV Year PET/CT or PET Facility Started Performing PET Studies, by Site Type, as of 2012 PET Census Survey...IV Year PET/CT or PET Facility Started Performing PET Studies, by Current PET Capability, as of 2012 PET Census Survey...IV Average PET/CT and PET Patient Studies Performed per Fixed PET/CT and PET Scanner, by Site Type, IV Average PET/CT and PET Patient Studies Performed per Fixed PET/CT and PET Scanner, IV Percent of PET/CT and PET Sites with Staff Types, as of 2012 PET Census Survey...IV Percent of PET/CT and PET Sites with Staff Types, by Current PET Capability, as of 2012 PET Census Survey...IV Percent of PET/CT and PET Sites with Staff Types, by Site Type, as of 2012 PET Census Survey..IV Mean Number of FTE Staff per PET/CT and PET Site Having that Type, as of 2012 PET Census Survey...IV Mean Number of FTE Staff per PET/CT and PET Site Having that Type, by Current PET Capability, as of 2012 PET Census Survey...IV Mean Number of FTE Staff per PET/CT and PET Site Having that Type, by Site Type, as of 2012 PET Census Survey...IV-100

8 13. Average Annual PET/CT and PET Patient Studies per Certified Technologist FTE at Fixed PET/CT & PET Sites, IV Percent of PET/CT or PET Sites Having Physicians Reading Scans, and Average Number of Physicians per Site Having, by Full- or Part-Time Status, as of 2012 PET Census Survey...IV Distribution of Sites, by Total Physicians in Department Who Read PET/CT and/or PET Scans, by Current PET Capability, as of 2012 PET Census Survey...IV Distribution of Sites, by Total Physicians in Department Who Read PET/CT and/or PET Scans, by Site Type, as of 2012 PET Census Survey...IV Average Annual PET/CT or PET Patient Studies Read per Physician per Site, by Current PET Capability and Site Type, IV Distribution of Sites that Send PET/CT or PET Scans to Off-Site Radiology Service to be Read, by Site Type, as of 2012 PET Census Survey...IV Hours per Week (Monday-Friday) PET Department Open for Scheduled Procedures, by Current PET Capability, as of 2012 PET Census Survey...IV Hours per Weekend PET Department Open for Scheduled Procedures, by Current PET Capability, as of 2012 PET Census Survey...IV Waiting Time for Non-Emergency Outpatient PET Study, by Current PET Capability, as of 2012 PET Census Survey...IV Waiting Time for Non-Emergency Outpatient PET Study, by Site Type, as of 2012 PET Census Survey...IV Waiting Time for Non-Emergency Outpatient PET Study, at all PET/CT and PET Sites, Fixed and Mobile, by Census Study, 2001 to IV Waiting Time for Non-Emergency Outpatient PET Study, at Fixed PET/CT and PET Sites, by Census Study, 2001 to IV PET Patient Studies per Thousand Population, by State...IV-107

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