¥553.8 Billion ($3.92 Billion)
Prior Fiscal: ¥513.3 Billion
Percentage Change: +0.8%
R&D Expenditure: ¥331.9B (total)
Best FY23 Quarter: Q4 ¥164.2B
Latest Quarter: Q1 ¥134.2B
No. of Employees: 169,151 (total)

Cleveland Clinic and Canon forged a strategic research partnership in November 2023 to establish a comprehensive imaging center.

The initiative merges a cross-institutional team of clinician scientists, researchers, and engineers to pioneer technologies focused on cardiology, neurology, and musculoskeletal medicine. It will have three major components—preclinical imaging, human imaging, and imaging analysis.

The center will become part of the Cleveland Innovation District, an over $500 million public-private partnership that brings the State of Ohio and JobsOhio together with Cleveland’s healthcare and higher education institutions to accelerate research, create jobs and educate the workforce of the future.

The synergy was a factor that attracted Canon to launch its Cleveland-based Canon Healthcare USA Inc. subsidiary in February 2023.

“This unique collaboration leverages Cleveland Clinic’s expertise in biomedical research and clinical care with Canon’s global leadership in imaging innovation and precision manufacturing,” said Tom Mihaljevic, M.D., Cleveland Clinic CEO and president. “By combining our strengths, we aim to create breakthroughs in imaging and work together to rapidly translate these innovations to improve patient care.”

“Under Canon’s ‘Made for Life’ philosophy, we are dedicated to improving the wellbeing of patients everywhere through our innovations in technology,” added Toshio Takiguchi, senior managing executive officer, Head of Medical Group, Canon Inc. “This collaboration with Cleveland Clinic allows us to use our mutual strengths to enable a future that delivers on this promise.”

Canon’s medical group pocketed $3.92 billion in the company’s fiscal year 2023 (ended Dec. 31), remaining flat at just under 1% the previous year. Investments in large CT and MRI systems recovered from postponement from the COVID-19 pandemic. The company highlighted MRI system growth with Vantage Fortian and Vantage Galan 3T products that use deep learning to boost image quality. European sales also blossomed because of each country’s policies to support medical equipment purchase.

The acquisition of in-vitro diagnostics (IVD) company Minaris Medical completed in July 2023 also fortified Canon Medical’s proceeds. The buy advanced its reagent business at full scale.

Canon Medical Systems began the share transfer agreement with Resonac subsidiary Minaris Medical in March 2023. Minaris added IVD agents and automated analyzer systems to Canon’s portfolio—the company’s reagents are used in core hospitals and major reference labs across Japan. Minaris is also developing its allergy testing business in the U.S. Canon Medical said it plans to leverage synergies between Minaris’ reagent tech and its automated biochemical analyzer technology.

The Aplio flex and Aplio go ultrasound systems debuted in July. Aplio flex is mobile with automated functions with pristine imaging and automated functions. Aplio go has a small form factor that supports a wide range of imaging tasks. Both systems tout a new set of lightweight transducers and suit stationary routine operation as well as mobile use.

July also saw the launch of the Zexira i9 digital X-ray RF system, a fluoroscopic table with a flat panel detector and new image processing tech. Zexira i9 lets staff move the field of view into the area needed during fluoroscopy without moving the table or X-ray tube. It also has a tomosynthesis function for digital tomography with slice info in the depth direction. Zexira i9 creates long images by automatically stitching images consecutively acquired while the X-ray tube moves.

In August, the new angiography system Alphenix/Evolve edition hit the Japanese, Asian, African, and European markets. Its real-time, deep learning tech enhances imaging while reducing time and radiation dose during routine and complex percutaneous coronary intervention and structural heart disease procedures. Its ɑEvolve Imaging leverages deep learning-based noise reduction and multi-frequency processing to allow sharp and clear fluoroscopic imaging, which can deliver two times higher contrast-to-noise ratio compared to conventional image processing. Dynamic Device Stabilizer (DDS) was trained with deep learning to automatically detect balloon markers in real-time, magnifying and stabilizing the image on a separate screen to assist stent visualization and assessment.

The Alphenix Sky 12 HD interventional system with the high-res HD 76 Hi-Def detector was released in September. According to Canon, it touts over twice the spatial resolution of conventional flat detectors. The system is used to improve visualization during interventional cardiology, interventional neurology, interventional oncology, and interventional radiology procedures.

November saw the unveiling of the company’s end-to-end CT workflow automation. The AI-powered tools were designed to boost confidence in the CT study process:

• • INSTINX provides patient positioning and quick scan planning and maintains consistency between operators regardless of level of experience.

• • Remote Assist allows direct virtual access from scanner to in-house experts to increase productivity and deliver high-quality care.

• • Automation Platform uses deep learning to streamline workflows and reduce manual intervention.

• • Vina Analytics CT protocol management features protocol review, comparison, approval, distribution, and revision history tracking.

November’s Radiological Society of North America (RSNA) meeting witnessed introduction of the Precise IQ Enginer (PIQE) deep learning reconstruction for MR. PIQE maximizes size, removes noise, and produces anatomical images. The application generates high spatial resolution images from low-res images and lets the matrix be tripled in both in-plane directions, a factor of nine times.

Canon Medical also introduced two new CT scanners at last year’s RSNA congress, Aquilion ONE/INSIGHT Edition and Aquilion Serve SP. Aquilion ONE/INSIGHT maximizes the inherent CT resolution for Super Resolution 1024 matrix images for cardiac and body exams. Aquilion Serve SP has an 80-cm wide-bore gantry with two touch screens and inbuilt cameras to support automated, one-touch patient positioning.

¥513.3 Billion ($3.89 Billion)
Prior Fiscal: ¥480.4 Billion
Percentage Change: +6.9%
R&D Expenditure: ¥306.7B (total)
Best FY22 Quarter: Q4 ¥150.8B
Latest Quarter: Q1 ¥131.1B
No. of Employees: 180,775 (total)

Nearing the end of 2022, Canon made a somewhat unusual (or at least uncommon) announcement. Companies often make news when acquiring a firm and bringing it aboard, or shedding itself of a division to be sold or become a standalone firm. Much less often, however, does a company establish a new business from scratch under the full control of the parent organization. Surprisingly, that’s just what Canon did. In November, the future for Canon Medical was revealed in the formation of Canon Healthcare USA.

This venture for the Japan-headquartered firm was estimated to require a $300 million investment. The goal of the endeavor was said to be an effort to strengthen the organization’s presence in the American medical industry, which “is extremely influential on the global market.” Cleveland was the primary consideration to serve as the home base for the new venture due to it being a healthcare hub.

As part of the plan, some marketing operations (specifically, upstream marketing) would transfer to Canon’s Global Marketing Center anticipated to have been established at the start of 2023. This move would enable the company to establish a network with medical institutions addressing healthcare concerns at the point of care so as to gain a better understanding of the market. That information would then be leveraged to develop new products and solutions to address the needs of the medical marketplace.

Another aspect of this plan would see the transfer of several products and services from Canon Medical Systems USA to Canon Healthcare USA. Combined with downstream marketing (i.e., directly communicating with customers), the firm could focus efforts on increasing market share in medical diagnostic systems within the U.S.

Still another part of this reorganization would see Quality Electrodynamics (QED), which Canon acquired in 2019, placed under the Canon Healthcare USA umbrella. QED develops and manufactures MRI components and could be used to help increase coordination between Canon’s system and component businesses.

The company stated the establishment of Canon Healthcare was to take place in January 2023, but no formal announcement has been made since. It was also unclear exactly which products would join the new entity, however, the company continued to roll out several new offerings during the year that could be put under the new banner.

One such offering, unveiled in June, provided a Cybersecurity Health Score and Utilization Management Dashboard to 360° Connect customers. The dashboard includes data visibility and analysis, allowing radiology teams to optimize workflow, increase performance, and make better-informed decisions throughout the patient’s examination process. The cybersecurity tool implements a high-level calculation that evaluates the risk to the facility by providing both the vulnerability and threat vector of its Canon assets.

Also during the summer, the firm launched its CXDI-Pro series of wireless digital radiography devices, including the CXDI-703C Wireless sensor unit, in markets outside of Japan. The CXDI-Pro series maintains the same basic functionality of its predecessor model, while realizing an improved body design and circuit architecture that facilitates greater ease-of-use and reduced workload for medical professionals.

In a partnership agreement, Canon has integrated Glassbeam’s Clinsights Utilization Analytics into its analytics suite. Clinsights is a cloud-based, vendor-agnostic solution that analyzes DICOM and HL7 data for every exam every day, and can scale to include all OEM solutions and imaging modalities in a single pane of glass. Canon Secure Analytics provides a turnkey solution including all hardware and software with installation.

In celebration of the 30th anniversary of Hybrid Angio-CT technology, Canon announced it had integrated the world’s first Deep Learning Spectral CT reconstruction and HD 76 high-definition imaging. Deep Learning Spectral CT reconstruction offers automatically-generated monochromatic images, material-specific reconstruction, and iodine maps—requiring no additional effort or training for technologists. In addition, the HD 76 high-definition detector provides more than twice the spatial resolution of conventional flat panel detectors, helping clinicians see fine details in complex interventional procedures.

Canon Medical Systems USA launched SP Configurations, Orian SP, and Galan SP in late November. These offerings feature AI-driven workflow solutions, an intelligent Ceiling Camera, and the Tablet UX mobile interface. In addition, SP configurations come standard with powerful 45 mT/m maximum gradient peaks and 200 mT/m/ms slew rates, the Fast 3D acceleration package, and ForeSee View automation—a real-time preview of the scan plan.

Joining this array of new products are also the portfolios that came via two acquisitions that took place during the latest fiscal. The company purchased Nordisk Røntgen Teknik A/S (NRT), a Danish company with advanced technology for the development and manufacture of diagnostic X-ray systems. According to Canon, NRT’s strength lies in its product portfolio, focusing on user-friendly, high-end systems and constant innovation with medical staff and patients in mind. The terms of the deal were not revealed.

Then, in the middle of the 2022 summer, Canon’s U.S. medical subsidiary declared it was buying NXC Imaging, a medical imaging equipment distributor and service provider headquartered in Minneapolis, Minn. The terms of this agreement were also not shared, but it did wrap within a month’s time following the initial announcement.

“We have partnered with NXC Imaging for over 33 years,” said Yuji Hamada, CEO and president of Canon Medical Systems USA Inc. “Our successful partnership has thrived due to Canon’s innovative technology and trusting collaboration with NXC’s entrepreneurial company culture. The results of our partnership have demonstrated strong results over the past 15 years in the Upper Midwest region.”

To showcase such a broad, diagnostic imaging portfolio, the organization embarked on its first “Truck Tour,” traveling across the U.S. to bring their solutions directly to hospitals and local healthcare providers. The road trip was conceived to provide a hands-on experience to create stronger community engagement throughout the year. The 50-city mobile tour kicked off in Canon Medical Systems USA’s Tustin, Calif., headquarters.

“Providing in-person experiences with current and new customers is key for us as a company. It’s a vital opportunity to connect, ask pressing questions in a face-to-face setting, and to learn more about better servicing their needs,” said David Hashimoto, vice president of Marketing and Sales Strategy. “We’re allowing unprecedented access to our technologies to better guide healthcare professionals with the essential information needed to make important decisions about their patients and business.”

In 2023, the tour expanded with the addition of a second truck and unique East and West Coast routes.

All of this effort, from new product introductions to the unique Truck Tour, was done to help continue to drive growth, which the firm has enjoyed in recent years. During its latest fiscal, the Medical segment reported revenue of ¥513.3 billion, which reflected a rise of 6.9% over the previous year. The 12-month period previous to that, it posted a 10.2% gain, so the organization seems to be seeking to continue that trend.

¥480.3 Billion ($4.17 Billion)
Prior Fiscal: ¥436 Billion
Percentage Change: +10.2%
R&D Expenditure: ¥287.3 Billion
Best FY21 Quarter: Q4 ¥128.5B
Latest Quarter: Q1 ¥118.2B
No. of Employees: 184,034 (total)

Peace and harmony.

These two words have been bandied about for centuries as an ideal goal for all humankind. They’ve also been tossed around corporate boardrooms of late as the means to a very prosperous end.

With global troubles like climate change, armed conflicts, and racial tensions impacting their bottom line, companies increasingly are embracing a societal moral duty. Multinational organizations realize the money-making tunnel vision of yesteryear no longer guarantees success; rather, good corporate citizenship is key to long-term prosperity.

Corporate social responsibility (CSR) is standard practice nowadays at most Fortune 500 companies. Conglomerates like Johnson & Johnson, Medtronic, Abbott, Philips, Stryker, Zimmer Biomet, Canon, and others routinely craft and/or engage in community improvement efforts or charity work.

Zimmer Biomet, for example, recently created an independent non-profit structure for Movement is Life Inc., a philanthropic, multi-disciplinary coalition it founded in 2010 to reduce musculoskeletal health disparities in minority populations. The coalition’s new non-profit structure will help Zimmer Biomet expand upon awareness programs that focus on early intervention, education, behavior change, and advocacy for chronic disease management.

Similarly, J&J created the Johnson & Johnson STEM Scholars Programme last year in the United Kingdom to provide financial support to Black students pursuing a STEM education. The five-year effort supports 25 students for two years, and a 10-student cohort for three years during their university tenure.

Canon, meanwhile, is helping young photographers, printers, and filmmakers in Africa through its Miraisha Programme, and improving both eye care and the overall quality of life in India. The company’s vision centers aim to prevent and/or treat cataracts, while its decade-old “Adopt a Village” venture provides community development assistance to underprivileged areas.

ANALYST INSIGHTS: Canon Medical has leapt forward in the last two years, as they have focused on strong partnerships throughout the pandemic that will better their future. They have been smart, strategic, and partnered with differentiated companies in order to increase their breadth of offerings, which should continue to help them expand into the future.

— Marissa Fayer, CEO, HERhealthEQ

Canon’s CSR programs are guided by its “kyosei” corporate philosophy—i.e., a “spirit of cooperation” in which individuals and organizations work together for the common good.

“A concise definition of [kyosei] would be ‘living and working together for the common good,’ but our definition is broader: ‘All people, regardless of race, religion, or culture, harmoniously living and working together into the future,’” Canon states on its global website. “Behind Canon’s 80-year history…lies its corporate DNA: a respect for humanity, an emphasis on technology, and an enterprising spirit that the company has consistently passed on since its foundation. Canon is committed to passing its corporate DNA on to future generations to ensure the company grows for another 100, or even 200, years.”

Such long-term prosperity certainly seems possible, given Canon’s most recent fiscal year performance. Total net sales swelled 11.2% in 2021 to ¥35.13 trillion, and operating profit more than doubled, reaching ¥281.9 billion. Canon attributed the growth to its pandemic recovery and business portfolio transformation (four new core reporting segments).

Canon scored gains in all geographic areas in FY21 (year ended Dec. 31), though its domestic sum paled in comparison to its overseas tallies. Improved computed tomography (CT) and diagnostic ultrasound system sales lifted Japanese revenue 3% to ¥830.3 billion, while American, European, and Asian/Oceanian proceeds benefitted from recovering product demand. Europe’s sales expanded 12.5% to ¥894.8 billion, Americas’ revenue mushroomed 13.7% to ¥968.8 billion, and Asia/Oceania’s sales surged 16.1% to ¥819.2 billion, according to Canon’s 2021 annual report.

Rebounding product demand also helped boost sales in Canon’s four business segments, though sporadic coronavirus caseload spikes and semiconductor chip shortages impacted results in the Printing and Imaging Business units, respectively.

Printing posted the lowest growth rate (7.4%) but the highest sales total (¥1.9 trillion), while Imaging amassed the highest gain (20.7% to ¥653.5 billion). Following close behind was Industrial and Others, which grew proceeds 18.2% to ¥545.7 billion, and Medical, which bolstered sales 10.2% to a record ¥480.3 billion.

Canon executives attribute Medical’s historic high to “returning routine exams,” but resurgent coronavirus infections, a semiconductor chip shortage, and shipping container backlogs stymied imaging systems production and installation throughout the year. CT and diagnostic ultrasound systems sales were amplified by recovering North American demand and “opportunities” within government-supported medical institutions in Japan.

Augmenting those “opportunities” was a bevy of product clearances and debuts. Canon Medical Systems USA Inc. expanded its CT portfolio with an acquisition and three U.S. Food and Drug Administration (FDA) clearances throughout 2021; the first clearance—in January—went to the Aquilion Exceed LB CT system, an artificial intelligence-powered machine designed to improve radiation therapy planning and delivery.

Aquilion Exceed aims to facilitate workflow while maintaining image quality and reproducibility. The system’s features include a 90-cm bore (the industry’s largest bore opening); 90-cm extended-to-edge field-of-view reconstruction; 4-cm wide detector coverage; AI-powered contouring, using Canon Medical Systems’ Advanced Intelligent Clear-IQ Engine deep learning reconstruction technology; and flexibility for handling bariatric patients as well as challenging patient positioning.

Three months after authorizing Aquilion Exceed, the FDA cleared Canon Medical Systems’ Deep Learning Spectral CT for use in cardiovascular applications. Available on the company’s Aquilion ONE/PRISM Edition CT system, the Deep Learning Spectral CT can capture whole-heart spectral images in one beat, by virtue of a 16 cm wide area detector, 0.275 second whole-heart acquisition with rapid kVp switching, and Deep Learning Spectral Reconstruction.

Designed for deep intelligence, the Aquilion ONE/PRISM Edition integrates AI technology to maximize conventional and spectral CT capabilities while providing deep clinical insights to assist physicians in making more informed decisions. Its fully integrated end-to-end workflow is easy to use and can be incorporated into routine protocols.

Canon Medical Systems’ final regulatory consent last year occurred in June with 510(k) clearance of the company’s Deep Learning Reconstruction (DLR) technology on its Cartesion Prime Digital PET/CT system. The Cartesion Prime with AiCE (Advanced intelligent Clear-IQ Engine) consistently and routinely produces high-quality images, thereby enabling better image quality and lesion visualization.

AiCE was trained using vast amounts of high-quality data, and features a deep learning neural network that can reduce noise and boost signal to quickly deliver, clear and distinct images, further opening doors for advancements in molecular imaging. AiCE on the Cartesion Prime Digital PET/CT can provide fast exams at a lower dose with better image quality than traditionally acquired during both the PET and CT acquisitions, according to Canon Medical Systems.

Ninety days after the Cartesion Prime clearance, Canon acquired Canadian chipmaker Redlen Technologies for ¥30 billion ($270 million) in a deal that will allow the company to develop CT scanners that reduce radiation exposure.

In addition to expanding its CT lineup, Canon Medical Systems bolstered its AI and cardiac imaging prowess last year. In April, the company equipped its Vantage Galan 3T MR System with AiCE DLR technology, expanding its clinical indications from FDA-cleared brain and knee scans to 96% of all procedures, including prostate, shoulder, all joints, cardiac, pelvis, abdomen, and spine.

Then in November, the company debuted new AI innovation brand Altivity, and Vantage Fortain, an advanced productivity, open-bore 1.5T MRI system featuring enhanced workflow solutions, image enhancement, and AiCE DLR technology for liver, prostate, and whole spine scanning.

Canon enhanced its cardiac imaging capabilities by partnering with Cleery Health and tweaking its Aquilion ONE/PRISM system. The Cleery collaboration integrates Canon’s AI-powered CT technology with Cleerly’s digital pathway solution for coronary artery disease analysis; the pairing is intended to identify heart disease as early as possible.

The Aquilion tweak adds Precise IQ Engine (PIQE) DLR technology to the scanner’s ONE/PRISM edition. “We’ve taken the Aquilion ONE/PRISM Edition to the next level of deep intelligence with PIQE,” Hisashi Tachizaki, vice president and general manager of CT System Division at Canon Medical Systems Corporation, said last fall. “Canon Medical continues to push what’s possible using AI. With PIQE, we are now able to further reveal essential diagnostic information for cardiac CT scans…”

$4.22 Billion ($30.6 Billion)
Prior Fiscal: $4.02 Billion
Percentage Change: -4.9%
No. of Employees: 181,897 (total)

Canon Group’s medical division developed and offered a suite of total solutions for diagnosing COVID-19 infections last year, including CT equipment, diagnostic X-ray and ultrasound systems, rapid genetic testing, and rapid antigen testing.

The firm also partnered with Japan’s Nagasaki University to develop and launch reagents for clinical COVID-19 RNA testing for novel coronavirus genes, used to test crew members and passengers of a cruise ship stuck in Nagasaki. Developed through joint research with Yokohama City University, Canon Medical launched sales of a COVID-19 antigen test kit as well. In the U.K., the Bradford Royal Infirmary took delivery of a Relocatable CT scanner equipped with a complete X-ray diagnostic system, making diagnostic imaging possible wherever needed and reducing infection risk among healthcare professionals.

Canon’s Medical Systems business comprised 13.8 percent of the company’s sales last year. The franchise offers digital radiography systems, diagnostic X-ray and ultrasound systems, CT and MRI scanners, clinical chemistry analyzers, and ophthalmic equipment.

The business segment accrued $4.22 billion of revenue last year, almost a 5 percent drop from the year prior. COVID-19 caused the delay of large equipment installations and business negotiations, but CT system demand for pneumonia diagnosis helped prevent further revenue losses. Diagnostic X-ray demand was also strong due to support to emergency medical system maintenance.

Last February the firm achieved FDA clearance for its Aquilion ONE/PRISM Edition CT scanner that enabled deep learning spectral capabilities for more routine spectral imaging. The clearance helps make more confident diagnoses thanks to rapid kV switching with patient-specific mA modulation, full field of view acquisition, and 16 cm of coverage.

A month later, the company won 510(k) clearance for Advanced intelligent Clear-IQ Engine (AiCE) on its Vantage Galan 3T MR system. Trained using enormous amounts of high-quality image data, AiCE’s deep learning neural network reduces noise and boosts signal to acquire sharp, clear, and distinct images. Vantage Galan 3T was also FDA cleared for Compressed SPEEDER technology in March, which speeds MRI scan times by reconstructing full-resolution images from under-sampled data via iterative reconstruction. In June, the technology was cleared for the Vantage Orian 1.5T MR system. Vantage Orian 1.5T MR was FDA cleared for AiCE technology in July as well.

Last April saw the release of the Aquilion Prime SP CT system, a deployable CT with a rapid decontamination solution. It’s deployable in a modular or mobile configuration, and its automated UV-C technology significantly reduces bacteria, spores, and viruses. Multiple UV-C emitters collaborate to decontaminate the room in minutes.

Designed for structural and coronary imaging’s evolving needs, the Aquilion ONE/GENESIS SP cardiovascular CT was introduced last July. It touts one-beat, whole heart acquisition and AiCE Deep Learning Reconstruction (DLR), automated tools from acquisition through analysis, a lower total cost of ownership, a 78 cm bore, and a wide and low couch.

Canon Medical launched the SOLTUS 500 mobile digital X-ray in August. It has a compact design with features to promote efficiency and safety, including tubehead controls and touchscreen display, increased detector wireless range and productivity, anti-collision technologies, pressure-sensitive steering, and simplified detector charging and storage capacity.

Aquilion Exceed LB CT was introduced during last October’s American Society for Radiation Oncology (ASTRO) annual meeting. It features AiCE DLR technology, a 90 cm bore opening, edge-to-edge extended field-of-view reconstruction, and 4 cm of detector coverage. The system is still pending FDA 510(k) clearance.

In November, the firm expanded AiCE DLR to additional modalities, clinical indications, and systems. It showcased AiCE DLR for the Cartesion Prime Digital PET/CT system at last year’s Radiological Society of North America (RSNA) meeting. The indication is pending FDA clearance.

The OMNERA 500A digital radiography system rolled out in November. The system enhances productivity via quiet, smooth auto-positioning, tube and detector auto-tracking, titling wall stand synchronization, and table/wall stand detector charging. System controls are strategically placed on the overhead tube crane (OTC). A specifically designed glass overlay OTC display facilitates cleaning and disinfection.

Also in November, Canon introduced Deep Learning Spectral CT for cardiovascular imaging, which enabled one-beat spectral cardiac CT imaging on the Aquilion ONE/PRISM edition CT. Thanks to a 16 cm wide area detector, the whole heart can be imaged in as little as 0.275 seconds, according to the company.

November was a very busy month for Canon Medical: it also saw the release of Automation Platform AUTOStroke software for CT scanners. The clinical workflow automation solution for CT uses deep learning AI algorithms to automatically complete stroke triage and identify large vessel occlusions or intracranial hemorrhages. When it spots a critical case needing immediate attention, it sends an alert so clinicians can mobilize and respond as quickly as possible.

The Aplio i-series ultrasound platform was endowed with a new liver reporting tool in December. The program uses measurements gathered via Shear Wave Elastography, which provides quantitative measure and dynamic visual display of liver tissue stiffness. The system also provides standard deviation and interquartile range data, as well as a simple visual propagation map, to ensure an accurate and confident “Rule of Four” application to determine cACLD and for assessment of other liver pathologies.

The company unveiled three expanded digital service solutions in December:

• • Gateway Platinum MVS: A cybersecurity solution with multi-vendor support

• • Glassbeam Clinsights: valuable analytics for increased productivity

• • PartsSource: An e-commerce distribution marketplace

A new size for the Hi-Def flat panel detector was introduced in December as well. According to Canon, the 12×16 Hi-Def detector provides over twice the spatial resolution of conventional flat panel detectors, helping see fine details in complex abdominal and peripheral procedures, including peripheral vessel stent placements, GI bleeding embolization, and endovascular leak repairs. The new size was made available for the Alphenix Sky + and Alphenix 4D CT with Sky + systems.

Compressed SPEEDER technology was FDA-cleared for 3D sequences on the Vantage Orian 1.5T in December. Compressed SPEEDER 3D boosts MRI scan times during 3D sequences for surgical planning and orthopedic applications by reconstructing full resolution images from under-sampled data through iterative reconstruction.

$4.02 Billion ($32.9B total)
Prior Fiscal: $3.96 Billion
Percentage Change: +1.5%
No. of Employees: 187,041 (total)

Toshiba’s professional video camera business has been integral to Japan-based Canon Medical since October 2016. Three years later, Canon acquired Toshiba America Information Systems’ Imaging Systems division, birthing a Video Sensing Division (VSD). The VSD will serve the health tech market as an OEM supplier in surgical imaging robotics and clinical microscopy.

“We are delighted to be part of the team at Canon Medical,” VSD director of sales Paul Dempster told Laser Focus World. “Our customers will continue to have access to the great products, service, and support they’ve become accustomed to. The distribution and authorized service providers for VSD products will remain the same. Additionally, manufacturing and quality inspection systems are not changing, so the product quality, availability, and product performance will continue to be of the highest caliber.”

Canon’s Medical System business was the only segment that posted a profit in fiscal year 2019, rising 1.5 percent to barely top $4 billion in sales. Domestic sales increased steadily thanks to a recovery of demand and a series of newly launched products. Sales in Europe tempered the increase with a sluggish first quarter performance.

Global Illumination rendering in the Vitrea advanced visualization platform was released everywhere but Japan last January. Physicians can use it to interact in real-time with photorealistic images and visualize patient anatomy in all dimensions. Patients can use it to understand their anatomy and pathology when communicating with their doctor. Forensic physicians will also be able to visualize anatomy prior to autopsy thanks to Global Illumination.

Last February, Canon Medical rolled out new software that enhanced the Celesteion PET/CT System with new acquisition and reconstruction techniques. Scan times and the acquisition mode can be adjusted per bed position and Respiratory Gating reduces dose in whole body PET scans to avoid extra scans. PET ECG phase image reconstruction scans can also be performed. PET image quality is improved by filtering noise while maintaining contrast, and a new reconstruction technique reduces metallic artifacts.

A radiation therapy package became available for the Aquilion Prime SB and Lightning 80 CT scanners last February as well to pair advanced imaging with oncology planning. It offers an extended field of view, scanning in one position, respiratory motion management, and LAP lasers to improve in-room patient setup and technologist workflow.

The Aplio a-series ultrasound systems debuted at last April’s AIUM meeting. High-resolution 2D imaging and volumetric ultrasound integrates into workflow for a range of imaging needs. The Healthy Sonographer Program provides CE accredited training and web support offering. Qualitative and quantitative tools like iSMI and Differential Tissue Harmonics help to meet a range of clinical needs.

The FDA cleared the Advanced Intelligent Clear-IQ Engine (AiCE), deep convolutional neural network (DCNN) image reconstruction for CT scanners, last June. Model-based iterative reconstruction (MBIR) reconstructs CT images with improved spatial resolution three to five times faster than traditional MBIR. AiCE uses deep learning to differentiate signal from noise, and the pre-trained DCNN enhances spatial resolution while reducing noise. It was green lighted by the FDA for the Aquilion Precision CT in October. AiCE began integration into Canon’s broader portfolio of CT and MRI scanners in December.

Low-dose lung cancer screening (LCS) was FDA-cleared for Canon Medical’s CT systems in September. The new LCS manages CT dose, protocols, and equipment. Automatic nodule tracking through advanced visualization spots lung nodules at an early stage. According to the New England Journal of Medicine, LCS reduces lung cancer mortality by 20 percent compared to standard chest X-ray.

The company completed a capital investment based on stock purchase with point-of-care testing research and development company FemtoDx in September as well. FemtoDx develops diagnostic methods to detect and notify about early signs of possible pathological events related to heart failure or stroke before they occur, leveraging mobile devices and AI technologies.

The firm launched the Alphenix Encore Plus Program in October. The program lets customers upgrade aging angiography systems while maintaining many existing parts like lights and shields. Among the upgrades are a large monitor, advanced cybersecurity, and a future upgrade path. Customers with existing Infinix-I systems can upgrade to the newer Alphenix platform, which was launched in 2018.

The Alphenix Aero Package was also introduced in October. Office-based labs and ambulatory surgical centers can use the package to tailor Alphenix Core and Alphenix Sky interventional imaging systems to fit their facilities’ needs.

“While hospitals get busier and reimbursement rates continue to change, the Alphenix Aero Package fits an unmet need in the healthcare space, enabling OBLs to grow their businesses and ensuring all physicians have access to the latest technology to deliver clinical excellence at a feasible budget,” Kristin Jones, acting managing director, Vascular Business Unit, Canon Medical Systems USA, told the press.

Swiss MRI research and development firm Skope Magnetic Resonance Technologies AG was acquired in November. Established in 2011, Skope develops and sells magnetic field monitoring systems and image reconstruction software for MRI scanners. The company’s expertise in MRI sensorics, signal processing, and image reconstruction achieve reproducible image quality, great image detail, and time-saving MRI scanning.

Last November’s Radiological Society of North America (RSNA) annual meeting witnessed the launch of the Cartesion Prime PET/CT system. It features advanced silicon photomultiplier design with one-to-one coupling and fast time-of-flight resolution, as well as large axial field of view and air-cooling for more attractive siting and long-term maintenance requirements compared to water-cooled systems.

Canon Medical also unveiled the Gateway Platinum multi-level cybersecurity solutions at last year’s RSNA meeting. Barracude NextGen Firewall notifies of security issues in real-time with on-demand reports and network health alerts fed into the customer’s security information and event management system alert engine. InnerVision Plus with Windows 10 helps increase productivity, boost system availability, and isolate imaging systems from outside threats before data is damaged or exposed. An “always on” secure site-to-site VPN tunnel provides multi-factor authentications to Canon Medical Control Center device access.

Compressed SPEEDER MR technology [pending 510(k) clearance] was also introduced at last year’s RSNA meeting for the Vantage Galan 3T and Vantage Orian 1.5T MRI scanners. The technology speeds MRI scans up to four times by reconstructing full resolution images from under-sampled data and shorter scans. It supports high acceleration and can help avoid artifacts while maintaining resolution and signal-to-noise ratio.

Announced in December, Canon transferred its eye care business operations from Canon USA Inc. to Canon Medical Systems USA on Jan. 1 of this year. The transfer added measurement systems, retinal cameras, and optical coherence tomography systems to Canon Medical Systems USA’s product line.

COVID-19 Consequences

Q1 2020 Revenue: $874.3 Million
Q1 2019 Revenue: $946.2 Million
Percentage Change: -7.6%

Although Canon Medical’s Diagnostic X-ray system and related component sales grew, cancellation of academic conferences and fewer trade shows cut opportunities for business discussion with customers. Entry restrictions and reduced sales/marketing opportunities further hindered sales, and installations at medical institutions were delayed due to COVID-19.

In late February, the company began developing a rapid genetic testing system for SARS-CoV-2. The project is part of a research program aimed at developing COVID-19 diagnostic methods, led by the Japan Agency for Medical Research and Development. Canon Medical was selected to participate in this program in cooperation with Nagasaki University.

AT A GLANCE
$3.96 Billion ($35.8B total)
Prior Fiscal: $3.95 Billion
Percentage Change: +0.25%
No. of Employees: 195,056 (total)

Naze son’nani aimaina nodesu ka.

It’s the “ka.” The “ka” makes that sentence confusing.

Actually, the “ka” isn’t confusing in this case. It can be confusing, depending on its usage. But it’s not universally confusing.

Konran shita? (Confused)?

“Ka” is the Japanese derivative of the question mark, used typically at the end of a full sentence to indicate a query—i.e., How are you? (Ogenki desu ka), Where do you live? (Anata wa doko ni sunde imasu ka), or What are you doing right now? (Ima nani o yatte imasu ka).

“Ka,” however, becomes semi-rhetorical when it indicates attentiveness to a conversation. Sou desu ka —is that so?—is the Japanese equivalent of “I see” or “hmmm.”

Moreover, “ka” also can represent expertise (following a job title) or indecision/uncertainty. And in some cases, it’s a conjunction (Doyoubi ka nichiyoubi ni umi niiku translates into “On Saturday or Sunday I will go to the beach”).

Wakari nikuidesu yo ne (Confusing, isn’t it?). Even more so without the “ka.” Depending on its placement, “ne”—like “ka”—can instantly turn a sentence into a rhetorical statement.

Clearly, the Japanese language has rightly earned its reputation for ambiguity, yet many linguists insist that social norms are the reason for vague phrasing. “The Japanese language can express anything it needs to,” Jay Rubin, a Harvard University professor of Japanese literature and translator of several Haruki Murakami novels, once noted, “but Japanese social norms often require people to express themselves incompletely or indirectly.”

Unlike Western culture, Japanese society places significant importance on the nuances behind words. Its language has at least 16 different ways to avoid saying “no,” and uses various expressions to reinforce feelings of interdependence and harmony. In Japan, people are rarely direct; since creating a mood is more important than the judgement, the word “no” is hardly used and “yes” may have various meanings (e.g., “I hear what you’re saying” or “yes, but…”).

Such sensitivity exists in the business world as well, albeit to a much lesser extent. Still, traditional rules of social interaction and customary language continue to influence Japanese corporate speak, producing a fresh cache of vague vocabulary. The term dantotsu, for example, has no legitimate English translation yet it nevertheless serves as a common benchmarking concept to foster greatness among Japanese firms. Over the years, dantotsu has been loosely translated as “better than the best,” “number one thinking,” and “best of the best.”

Some companies have put their own spin on the word in their quest for entrepreneurial supremacy—Komatsu Ltd. (construction/mining machinery), specifically, defines dantotsu as unique/unrivaled and has incorporated that meaning into its overall business strategy.

Canon Inc. has adopted a dantotsu blueprint as well. The multinational imaging/optical solutions manufacturer is aiming to expand its market share of dantotsu products (those with “extraordinary features” that cannot be imitated) through improved R&D, focused investments, and digital technologies.

“The first challenge is to reinforce our existing businesses. We will utilize such technologies as the Cloud, IoT [internet of things], and AI [artificial intelligence] to advance the development of Dantotsu products that dominate the competition,” Canon Chairman and CEO Fujio Mitarai wrote in a 2018 shareholder letter detailing the company’s strategy for achieving maximum productivity. “The second challenge is to strengthen and expand new businesses. We will accomplish this through concentrated investments in commercial printing, network cameras, medical, and industrial equipment, the four businesses Canon views as the pillars to its future success.”

Mitarai might need a new Dantotsu game plan based on the pillars’ past performance, though. Fiscal 2018 revenue fell 3.1 percent to $35.79 billion due to a contracting interchangeable-lens camera market and lower OLED vacuum deposition equipment sales. All geographic regions experienced sales declines, ranging from a 1.3 percent dip in Europe to a 1.7 percent slide in Japan and a 6.5 percent drop in Asia and Oceania. The Americas posted a 0.7 percent fourth-quarter increase but still ended the year 2.8 percent below its 2017 total, according to Canon’s annual report.

Operating profit swelled 8.5 percent to $3.11 billion as three of Canon’s four business units (pillars) grew revenue. The gains, however, were minimal at best: Industry and Others proceeds climbed 1.6 percent (a company high), while Office sales remained basically flat, rising only 2.51 billion yen (0.1 percent) from its 2017 total.

The Medical Systems unit (a.k.a. Canon Medical Systems), which comprised 11 percent of the company’s 2018 sales total, increased revenue 0.3 percent to $3.96 billion (437.57 billion yen) and grew operating profit 31.4 percent. Strong demand for new diagnostic ultrasound systems, magnetic resonance imaging (MRI) solutions, and compact lightweight products mostly drove sales growth.

Some of that demand’s sources were Aplio i-series ultrasound updates, and a next-generation interventional platform (Alphenix).

The latter innovation incorporates new features for better image clarity and precision as well as low dosage. The improved imaging is offered via a new 12-by-12-inch Hi-Def Flat Panel Detector (available on the Alphenix Biplane and Alphenix Core + systems) that produces resolutions of 2.6 lp/mm (standard) and 6.6 lp/mm (hi-def). The Hi-Def Detector helps clinicians see finer details during complex interventional procedures like stent positioning and stent apposition, wire and catheter navigation through stent struts, and coil deployment observation.

The Aplio updates affect the i800 and i900 models. The latest i900 version—designed specifically for advanced cardiovascular cases (i.e., transcatheter implantation) integrates various 4D capabilities such as 4D TEE transcatheter guidance and MVA (mitral valve analysis), which helps to prep, implant and review the new valve’s performance. Other features consist of  Ejection Fraction with Global Longitudinal Strain, MPI (Myocardial Performance Index), and 3D Wall Motion Tracking.

The most current Aplio i800 model introduces an industry-first 33 MHz ultra-high frequency linear transducer to provide extremely fine detail and spatial resolution in the near field. The ultra-high frequency transducer uses intelligent Dynamic Microslice (iDMS) and Superb Micro Vascular Imaging (SMI) technologies to provide high resolution and detail for B-mode and Color Flow imaging, making the Aplio i800 ideal for superficial subcutaneous imaging, small joint and superficial nerve exams, and superficial vascular evaluations. Moreover, Smart Sensor 3D enables clinicians to obtain accurate volume images with the 33 MHz transducer, also in SMI mode, and visualize microvascular structures in 3D.

In addition to the updates, Canon Medical Systems expanded its Aplio ultrasound portfolio through the U.S. Food and Drug Administration clearance of the i600 in March 2018. The small, lightweight device is designed to improve ease of use and productivity, and features an image-guided user interface for simpler exam navigation. The i600 also is equipped with the company’s iPerformance imaging technology, which reportedly reduces clutter and improves visualization.

The Aplio i600 clearance was one of several new products to receive the FDA’s blessing last year. Other innovations securing authorization included:

• • The Vantage Galan 3T XGO Edition cardiac MRI scanner. The product’s advanced gradient and imaging software can provide up to 30 percent signal-to-noise ratio for brain diffusion weighted imaging (DWI) to produce higher resolution images. MultiBand SPEEDER software allows for multiple slices to be conducted simultaneously, and reduces diffusion weighted imaging scan times by two-fold. The Galan 3T XGO also delivers enhanced cardiac capabilities, including T1 mapping that uses Modified Look-Locker Inversion recovery sequence and allows providers to obtain a more quantitative characterization of myocardial tissue within a single breath hold. The system’s Phase Sensitive Inversion Recovery in the heart provides improved contrast in late-enhanced imaging and eliminates the need for an inversion time calibration scan.

• • The Aquilion Precision CT system, touted as the world’s first ultra-high resolution computed tomography platform. The system can resolve anatomy as small as 150 microns and is designed to provide more than twice the resolution, which is typically seen only in catheter labs. The Aquilion Precision contains new detector, tube, gantry and reconstruction technologies to expand the visualization of disease. Its detector channels are 0.25 mm thick, and its resolution capabilities have never before been achieved in CT imaging (according to Canon), thanks to a 0.4 mm by 0.5 mm Focal Spot Tube and a routine 1024 by 1024 Reconstruction Matrix.

• • The Vantage Orian 1.5T MRI system offers high performance imaging capability not previously available on Canon Medical’s 1.5T machines. The Vantage Orian has a new slim gradient that delivers a performance with a maximum amplitude of 45 mT/m, combined with a 200 T/m/s/ slew rate to enhance high resolution and diffusion imaging. It also features technology to reduce scan time and help improve workflow. A redesigned gantry interface and dockable table ensure seamless patient handling; new applications like Multiband SPEEDER and k-t SPEEDER allow for high-frame-rate cine cardiac and perfusion imaging with free breathing.