Market evolution: X-ray apparatus (CN 9022) — 2015–2025

Introduction

This report examines the evolution of EU trade in apparatus based on the use of X-rays or of alpha, beta, gamma or other ionising radiation (Combined Nomenclature heading 9022) over the period 2015–2025. The product scope is broad, encompassing medical, surgical, dental and veterinary radiography and radiotherapy equipment, computer tomography (CT) scanners, X-ray tubes, high-tension generators, and associated parts and accessories. The EU has consistently maintained a large trade surplus in this sector, and the data reveals a story of robust export-led growth, a geographic reorientation of both suppliers and customers, and divergent fortunes among product sub-segments. The analysis draws on overall trade data, partner-level breakdowns, intra-EU reporter data, concentration and specialisation metrics, vulnerability indicators, and product segment breakdowns.

1. A Widening Surplus: The EU's Expanding Position as a Net Exporter

The EU entered the period with a decisive trade surplus in CN 9022 and has since reinforced that position. Over 2015–2025, the surplus widened by approximately 33% in value terms, while both export and import flows grew at different paces. This section documents the headline trade dynamics and explains what they imply for the EU's competitive standing.

1.1 Exports grew faster than imports in absolute terms, widening the surplus

Between 2015 and 2025, EU extra-EU exports of CN 9022 rose from €5.79 billion to €8.12 billion (+40.3%), while imports climbed from €1.99 billion to €3.08 billion (+54.3%). Although the rate of import growth exceeded that of exports, the absolute increase in exports (€2.33 billion) far exceeded that of imports (€1.08 billion), pushing the trade surplus from €3.80 billion to €5.04 billion.

The net import reliance indicator remained deeply negative throughout (from −77% in 2015 to −150% in 2025), confirming that the EU is a structural net exporter. The intensifying negativity reflects a growing export surplus relative to domestic apparent consumption.

1.2 Price and volume both contributed to export growth

EU export growth was driven by a combination of rising volumes and rising unit prices. Export volumes (in net tonnes) increased from 43,395 t to 53,086 t (+22.3%), while the export unit price per tonne rose from €133,421 to €153,004 (+14.7%). This indicates that the EU is not merely shipping more equipment but is also commanding higher average values, consistent with a shift toward higher-value-added products such as CT scanners and advanced radiotherapy systems.

On the import side, volumes grew more steeply (+34.2%, from 24,206 t to 32,485 t), while the import unit price also increased by 15.0% (from €82,406 to €94,751 per tonne). The persistent gap between export and import unit prices (roughly 60% higher on the export side) underscores the EU's position in the premium segment of the market.

1.3 EU production expanded strongly, reinforcing outward orientation

According to available production data, EU production of CN 9022 goods rose from €4.37 billion (143,374 units) in 2015 to €8.29 billion (345,010 units) in 2025—an increase of 89.8% in value and 140.6% in quantity. Export propensity rose from 71.8% to 97.1%, and trade intensity climbed from 78.0% to 97.9%, indicating that the EU's X-ray and radiation equipment sector is deeply integrated into global markets and increasingly oriented toward exports.

2. Geographic Reorientation: Asia's Rising Weight and Diversifying Supply Chains

The geographic composition of both the EU's customer base and its supplier base shifted considerably over the period. Asian economies—particularly China, India, and South Korea—grew in prominence on both the import and export sides, while traditional partners such as Japan and the United Kingdom showed more mixed trajectories. This section examines how the map of trade relationships evolved and what concentration metrics reveal about risk.

2.1 The United States remained the dominant partner, but Asia gained ground

The United States continued to be the EU's largest single trade partner for CN 9022 on both the export and import sides throughout the period. EU exports to the US grew from €1.91 billion to €2.61 billion (+37.1%), accounting for roughly one-third of total extra-EU exports. Imports from the US edged up only marginally, from €935 million to €943 million (+0.8%).

The most dramatic shifts occurred on the import side with China, whose exports to the EU surged from €214 million to €756 million (+253.5%), making it the second-largest import source by 2025—overtaking Japan and the United Kingdom. South Korean exports to the EU more than doubled (+128.5%), and Indian shipments nearly tripled (+190.0%). On the export side, EU shipments to China grew by 70.5% to €1.33 billion, while India became an increasingly important market with exports more than doubling (+108.6%).

2.2 The United Kingdom saw import growth after Brexit, while Russia's role fluctuated

Imports from the United Kingdom grew from €224 million to €362 million (+61.5%), partly reflecting the post-Brexit reclassification of UK–EU trade from intra-EU to extra-EU flows. EU exports to the UK rose more modestly (+9.1%, from €383 million to €418 million). EU exports to Russia showed a notable peak around 2018–2019 (up to €398 million in one year) before declining back to €186 million by 2025, likely reflecting the impact of geopolitical sanctions. However, the overall change from 2015 to 2025 was still positive (+9.6%).

2.3 Import concentration decreased while export patterns remained stable

The Herfindahl–Hirschman Index (HHI) for import value fell from 2,670 to 1,909 (−28.5%), indicating a meaningful diversification of the EU's supplier base. In 2015, imports were more heavily concentrated in the United States; by 2025, the rise of China, South Korea, and India had spread import sources more evenly.

The export HHI remained essentially flat (1,410 to 1,420, +0.7%), reflecting a stable destination structure in which the US, China, UK, Russia, and Japan continued to absorb the bulk of EU exports.

2.4 Germany and the Netherlands dominated intra-EU export performance

Among EU Member States, Germany was the overwhelmingly dominant exporter, with extra-EU exports rising from €3.02 billion to €4.15 billion (+37.2%)—over half the EU total. The Netherlands was the second-largest exporter, growing from €1.28 billion to €2.06 billion (+60.7%), partly reflecting its role as a distribution hub. Italy showed the fastest growth among major exporters (+86.6%, reaching €284 million), while France's exports declined slightly (−8.0%).

On the specialisation front, Finland (RSCA: 0.49), France (0.32), Germany (0.26), and the Netherlands (0.24) displayed revealed comparative advantage in CN 9022 exports in 2025. By contrast, most smaller EU economies had negative RSCA values, indicating net specialisation in other product categories.

3. Product-Segment Divergence: CT Scanners and X-ray Tubes Drive Growth, Dental and Radiation Equipment Stall

Not all sub-segments within CN 9022 followed the same trajectory. CT scanners (902212) and X-ray tubes (902230) emerged as the fastest-growing categories, while dental X-ray equipment (902213) and medical ionising radiation apparatus (902221) experienced declines. This section breaks down the segment-level evolution on both the export and import sides.

3.1 CT scanners became the EU's fastest-growing major export segment

EU exports of computer tomography apparatus (902212) surged from €876 million to €1.80 billion (+105.4% in value), driven by a combination of higher volumes (from 6,988 t to 13,202 t) and consistently high unit prices (around €136,000/t by 2025). CT scanners thus more than doubled their share of total CN 9022 exports, reflecting the global expansion of diagnostic imaging infrastructure.

On the import side, CT scanner imports also grew, from €347 million to €453 million (+30.5%), but at a far slower pace than exports, reinforcing the EU's net-exporter position in this high-value segment.

3.2 X-ray tubes emerged as the fastest-growing import category

Imports of X-ray tubes (902230) rose from €149 million to €370 million (+148.7%), making it the fastest-growing import sub-segment by percentage. This growth may partly reflect the restructuring of global X-ray tube supply chains, with more production occurring outside the EU (notably in China and South Korea). Meanwhile, EU exports of X-ray tubes also grew strongly, from €293 million to €683 million (+133.0%), suggesting that both production and trade in this component intensified.

3.3 Dental X-ray and medical radiation apparatus lost ground

Two segments bucked the overall growth trend. EU exports of dental X-ray apparatus (902213) declined from €335 million to €197 million (−41.2%), while export volumes fell from 2,805 t to 1,620 t. This contraction likely reflects increasing competition from Asian manufacturers (particularly Chinese) in the commoditised dental imaging segment, combined with a shift toward digital and intra-oral systems that may be classified differently.

Medical ionising radiation apparatus (902221) saw imports collapse from €47 million to just €10 million (−78.8%), while exports fluctuated (€84 million to €106 million). The sharp import decline may indicate that the EU has achieved greater self-sufficiency in this niche, or that the category has experienced classification shifts.

3.4 Parts, accessories, and non-medical equipment showed steady value growth

The parts and accessories segment (902290) was the largest single import category (€1.26 billion in 2025) and the third-largest export category (€1.77 billion). Its steady growth on both sides of the ledger reflects the EU's role as both a producer and assembler of high-end imaging equipment, requiring substantial inflows of components and sub-assemblies.

Non-medical X-ray equipment (902219) — used in industrial inspection, security screening, and scientific applications — saw exports grow from €533 million to €854 million (+60.1%), suggesting growing demand from manufacturing quality control and non-destructive testing markets globally.

Conclusion

Over the 2015–2025 period, the EU consolidated its position as the world's leading net exporter of X-ray and ionising radiation apparatus, with the trade surplus rising to €5.04 billion. This performance was anchored by Germany and the Netherlands, sustained by strong growth in CT scanners and X-ray tubes, and supported by rising export unit values that reflect a premium product mix. At the same time, the geographic landscape shifted notably: China transformed from a minor import supplier into the EU's second-largest source (€756 million), while also becoming the EU's second-largest export market (€1.33 billion). Import diversification, as measured by the declining HHI, reduced concentration risk on the supply side, though it also brought new competitive pressures—particularly in dental imaging, where EU exports contracted significantly. Looking ahead, the EU's deep export orientation (with export propensity approaching 97%) leaves the sector well-positioned but also exposed to geopolitical and trade-policy shifts, especially in the context of rising competition from Asian manufacturers and evolving medical device regulations.