CT scan machine room
Do I Purchase A New Or Refurbished Computed Tomography?
31st January, 2023 14h44
When considering the purchase of a computed tomography system for the first time, it may seem financially attractive to opt for a refurbished CT system. But a closer look at the new and refurbished acquisition reveals significant differences, not only in terms of imaging quality.
DiploVets has summarised the most important differences, advantages and disadvantages of each option:
New CT modality
- Energy efficiency: A CT system requires a lot of energy for air conditioning and use. Due to the optimised technology, the reduced size of the CT units and the lower required radiation dose, modern computed tomography is more energy-efficient. When making a shortlist for a CT, it is worth considering the expected annual consumption of the possible models. This data can often be obtained from the manufacturer.
- Image quality: The quality of CT studies depends to a large extent on the age of the scanner. The more recent the unit is, the higher the resolution and image quality will be. Modern systems can enable multiple reconstructions through a single scan and work in a matter of seconds. This contributes to greater diagnostic certainty, a wider range of examination options and faster workflows. Efficient workflows may also enable shorter anaesthesia or sedation regimens, which are required for most examinations.
- Lifetime and Warranty: Lifetimes for the tubes, which are the most significant wearing part, are usually given by manufacturers as 10 years. Some manufacturers provide a guarantee for the whole tube's lifetime. In general, new equipment is subject to specified warranty periods. During this time, all defects are repaired without charge.
- Size: Modern technology also aims to minimise the size of the CT systems. Cost- and time-intensive building alterations can thus be reduced.
- Support and Installation: When purchasing a new CT system, one often also establishes a long-term relationship with the provider for training as well as for maintenance and repair measures. Some providers even offer a collaboration that is based on the specified lifetime of the tube. These service packages are often more favourable than adding support to a refurbished system. If building alterations are necessary, companies can assist you with their experience and expertise.
- Veterinary specificity: Some modern CT units are adapted to veterinary medicine. These CT systems optimally contain anatomical presets and software for veterinary medicine, which will allow the CT unit to be used quickly, routinely and without additional adaptation effort for specialised protocols. Ideally, the service team will include employees specially trained and experienced in veterinary medicine. This will greatly reduce the time and staff needed to set up the CT system, thus saving costs. The used equipment market, on the other hand, usually offers equipment from human medicine.
- Technology: A computed tomography system needs regular updates. New CT systems usually include this option in service contracts, which lead to ensuring you are always using the most advanced technology available
… Purchase price: Certainly, there is a high acquisition price and thus financial risk. Of course, before buying a new modality, it is necessary to calculate as accurately as possible whether the acquisition costs pay off and whether my case load is high enough.
With detailed prior planning, a good business model and an optimum utilisation of capacity, the financial risk can be minimised. Similarly, the risk of unexpected costs is minimal, as they are usually covered by the warranty and included in the service package thereafter.
Second hand modality
Used and refurbished are two different concepts. Refurbished scanners are usually overhauled with replaced worn parts and include certain warranty services. As manufacturers apply different and more stringent testing procedures, it's important to consider whether this is done by the manufacturer itself or a third-party supplier. Some distributors award certain seals of approval from manufacturers that guarantee proper reprocessing or are otherwise certified, e.g. according to FDA regulations.
Used equipment is mostly resold without further inspection and worn parts, like the tube, are not replaced.
⇒ Important technology updates are always limited for both.
When compared to a new CT system, refurbished systems often differ in the following ways:
- Installation and disposal costs: Older CT units are often even larger and therefore require possibly higher building alterations. It is also expected that the runtime will be shorter and the conversion measures may no longer be suitable for the subsequent CT system. If you want to dispose of a used CT, you will most likely not find a reseller for it, but have to bear the decommissioning and disposal of the unit yourself.
- Operating costs and energy demand: Power requirements are often higher for older electronic CT units. This can lead to high operating costs.
- Quality: Image quality is constantly being improved, which in turn improves the quality of veterinary work. A model with outdated image quality does not meet the high demands of the radiologist or examiner for modern diagnostics and therapy.
- Service: In most cases, the purchase price includes only the CT unit itself but may, at times, include the installation. Since these must also be paid in addition to the computed tomography, it is often impossible to provide the same services for older than for new systems due to the outdated technology.
- Technology: An older CT system contains older technology. The latest technologies or novel functions are not yet integrated and subsequently upgrades are not possible. Veterinary protocols or reconstructions can't be used in some cases because the equipment isn't compatible with new technology. This is comparable to an outdated version of Windows on a 10-year-old computer - you can work with it, but only limited and not on a modern level.
- Tubes and other spare parts: Spare parts for older equipment are difficult or impossible to obtain on the market and can lead to unimagined costs, since the procurement effort is so high. Therefore, if an important wearing part breaks, this can paralyse the entire operation of the system. If the tube has not been replaced, it is essential to find out how often and how long the tube was used. Broken tubes lead to artefacts, which reduce the quality and informative value of the images to the point where they can no longer be evaluated.
- Warranty: The warranty is shorter and limited: usually 6 months, with no all-round guarantee.
… Purchase price: The price range between new and refurbished CT scanners varies considerably depending on the CT unit and its age. The purchase costs cannot be considered isolated: The acquisition is always linked to the additional installation-, training -, and further service-contract you need.
A lower financial investment appears to be less risky, but additional costs may arise, which must be tried to consider in the cost calculation. Sometimes, hidden or considered costs can be so costly that they exceed the financial scope.
However, it must be understood that when costs are saved, it is impossible to achieve the highest image quality!
If you have a small or medium-sized clinic, purchasing a refurbished CT scanner may be the best business model for you if you are reluctant to make the financial commitment of a new CT system. When purchasing a refurbished system that has passed the manufacturer’s tests, the upfront cost will be slightly lower than the price of a new CT.
Contact the manufacturer with the serial number of the CT unit you are considering and ask for available information such as date of first manufacture, which will then give you an idea of how long the system could be supported. It is possible that you will get 5 years of service out of a refurbished CT system, but within that time frame, you should have a good idea of your caseload which may support replacing it with a new CT system.
Leasing and subscription
Some distributors also offer different business models, such as leasing or subscription, which are often not rigid but flexible and negotiable.
A little negotiation skill can lead to good offers without taking a big financial risk. One possible disadvantage, depending on the contract, is that the profit margin is reduced.
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