In the photon-counting CT era, why did Neusoft build the world's first 1024-slice CT?

Neusoft Medical has recently announced that its independently developed 1024-slice panoramic multi-modal CT system, "NeuViz 1024," has received approval from the National Medical Products Administration for market entry in China, marking it as the world's first commercially approved "thousand-slice" CT system.

NeuViz 1024 Certificate of Registration Basic Information

This achievement represents yet another significant breakthrough for Neusoft Medical, following its acquisition of China's first registration certificate for a wide-body photon-counting CT system in August of this year. In the field of CT technology, Neusoft Medical stands among a cohort of leading Chinese high-end manufacturers that have successfully entered the forefront of global innovation.

It is reported that the NeuViz 1024 is equipped with a high-definition imaging chain ranging from the detector to the reconstruction algorithm, featuring an ultra-thin slice thickness of 0.3125 mm. The system achieves a spatial resolution of up to 46.5 lp/cm (compared to the 40 lp/cm spatial resolution publicly stated for the Canon photon-counting CT TSX-501R), realizing photon-counting-level microscopic detail on a conventional energy-integrating detector platform.

According to the imaging data released by Neusoft Medical, the NeuViz 1024 can clearly visualize fine anatomical structures such as the inner ear, oral cavity, and trabecular bone. This capability provides new tools to support deeper levels of precision diagnosis, treatment, and scientific research.

 NeuViz 1024 Inner Ear Ossicles Imaging

Furthermore, the NeuViz 1024 is equipped with an ultra-wide 16cm detector. This application delivers exceptional results: in cardiac imaging, a single rotation scan can cover the entire heart. Combined with high-definition image quality, it not only "freezes" instantaneous cardiac motion but also clearly reveals subtle plaques and structures within the coronary arteries. In thoracic scanning, a single scan enables large-range pulmonary vascular imaging, enhancing both patient comfort and safety while significantly improving diagnostic accuracy and efficiency for conditions such as pulmonary embolism.

 High-definition Imaging of Coronary Calcified Plaques

However, given that the first-generation photon-counting CT system P10, approved for market access in August, has already established advantages in resolution, dose, and energy performance—securing its status as the "next-generation CT"—traditional energy-integrating detector technology faces inherent physical hardware limitations that hinder further breakthroughs. In light of this, why does Neusoft Medical continue to invest in the traditional EID pathway by developing such a thousand-slice CT system?

From the perspective of detector technology pathways, although the photon-counting detectors of photon-counting CT far surpass traditional energy-integrating detectors in terms of development potential, in the short term, conventional EID systems may still catch up with the current generation of photon-counting CT in areas such as resolution and dose performance.

Relevant industry forecasts suggest that traditional EID detectors will retain the capability to compete with photon-counting CT for at least another 8 to 10 years.

In this view, the introduction of neural networks and the integration of deep learning have extended the viability of traditional EID technology. With AI enhancement, conventional EID systems can address inherent trade-offs such as balancing DSA radiation dose with image quality, managing low-dose CT noise, and mitigating low-contrast loss due to ultra-thin CT slices. By leveraging existing high-quality data as training sets to augment performance under constrained conditions, AI enables the reconstruction of high-quality images—a form of legitimate and efficient optimization.

Returning to the NeuViz 1024, this CT system exemplifies how AI integration resolves many such dilemmas. For instance, its AI algorithms can intelligently remove noise at an extremely fine pixel scale, significantly reducing radiation dose while fully preserving anatomical details.

Furthermore, advances in high-performance computing engines have made the post-processing of ultra-high-slice imaging practically efficient. Even when processing massive datasets from 1024- or even 2048-matrix acquisitions, the system can rapidly reconstruct images, allowing clinicians to view clear results in real time.

In summary, while current photon-counting CT systems hold certain advantages over ultra-high-end EID CT in terms of lower radiation dose and higher resolution, the NeuViz 1024—with AI augmentation—can achieve comparable performance and even deliver a superior workflow experience for physicians, outperforming photon-counting CT in practical clinical usability.

Examining the production aspect, the photon-counting detectors used in photon-counting CT employ wide-bandgap semiconductor materials such as cadmium telluride and cadmium zinc telluride. These materials can directly convert absorbed X-ray energy into electrical signals without the need for reflective septa. Consequently, using PCD allows for a significant reduction in detector pixel size without compromising geometric detection efficiency, with photoelectric absorption accounting for over 95% of the process. This enables photon-counting CT to achieve a notable advantage over high-end energy-integrating detector CT in areas such as resolution and energy discrimination.

However, mass-producing wide-bandgap semiconductor materials is extremely challenging. In nature, cadmium telluride takes approximately 3 million years to form, while cadmium zinc telluride does not occur naturally and requires extreme conditions for synthesis.

Siemens Healthineers, the current market leader in photon-counting CT, spent over 10 years and invested more than €600 million to achieve a breakthrough in cadmium telluride mass production technology. In 2023, the company further invested €80 million to build a new semiconductor plant in Forchheim, Germany, expected to commence operations in 2026 to further expand production capacity.

Both Neusoft Medical and United Imaging Healthcare utilize cadmium zinc telluride as the raw material for their detectors. However, as both companies started their research, development, and regulatory approval processes later than some competitors, and given the limited number of Chinese enterprises capable of mass-producing cadmium zinc telluride, it can be inferred that it will still take considerable time for them to achieve mass production sufficient to meet the demands of the Chinese market.

Nevertheless, the current imaging equipment market may not afford them much time. Since 2025, major provinces and municipalities such as Sichuan, Henan, Hebei, and Xinjiang have successively launched centralized procurement programs for medical equipment, aiming to replace outdated devices and cover new institutions through a "price-for-volume" strategy.

Centralized procurement applies price reductions across brands, types, and tiers, with mid-to-low-end devices experiencing greater declines than mid-to-high-end ones, particularly in the first half of the year. For example, in the equipment renewal initiatives for county-level medical alliances, prices have plummeted to near-production costs: 1.5T MRI systems are now priced around 2 million RMB, 64-slice CT scanners at approximately 1 million RMB, and full-body ultrasound systems priced at under 500,000 RMB. This has nearly exhausted all room for further price reductions.

In contrast, the impact of centralized procurement on high-end and ultra-high-end devices remains manageable. These devices inherently have higher profit margins and lower sales volumes. Limited price reductions combined with increased sales volumes mean that centralized procurement has not significantly affected manufacturers negatively.

For instance, in Health Commission of Zhejiang Province's ultra-high-end CT procurement project, GE Healthcare's 256-slice quantum CT Revolution Apex Expert was sold at 15.937 million RMB per unit, with four units purchased, representing a price reduction of 21.3% to 37.1% compared to public bidding prices in 2024. United Imaging's 320-slice uCT960 saw a slightly larger reduction, priced at 9.89 million RMB per unit with three units sold, reflecting a decrease of 37.4% to 41.1%.

For all Chinese medical imaging equipment manufacturers, centralized procurement represents a watershed moment. The excessive procurement of CT and MRI devices during the pandemic has led to saturation in the mid-to-low-end market in China. This year's centralized procurement serves as a market reshuffle: as low-end devices lose profitability, betting on high-end equipment becomes the only viable path for sustainable growth.

Even before this year's centralized procurement initiatives, multinational corporations had significantly reduced their investments in the mid-to-low-end market, shifting resources toward mid-to-high-end segments. Siemens Healthineers, in particular, managed to avoid a significant decline in its China revenue despite the challenging economic cycle and trade conflicts.

For Neusoft Medical and United Imaging Healthcare, the rapid sales growth both companies achieved before 2022 relied heavily on their swift penetration of the mid-to-low-end market. The revenue generated from these segments also provided the necessary capital to establish a foothold in the high-end market.

Now, both companies must further increase the contribution of high-end devices to their overall sales. As the centralized procurement market approaches saturation, sustaining growth will depend on high-end and ultra-high-end equipment taking the lead.

It is worth noting that the high-end and ultra-high-end CT market is expected to become highly competitive by 2026. In November, GE Healthcare submitted its deep-silicon photon-counting CT(Photonova Spectra to the FDA for 510(k) premarket notification, while China's Vital Healthcare may also achieve breakthroughs in market approval for its photon-counting CT.

Before the mass production and market validation of photon-counting CT, NeuViz 1024 needs to bear the pressure of the transition period, helping Neusoft Medical secure its position in the ultra-high-end market until the arrival of a new era.