Emerging Trends in Ultrasound Imaging

 By Karen Koblan, Ultrasound Solutions Corp.

We are close to a new era in ultrasound technology. From helping healthcare specialists detect several diseases such as cancerous cells to showing real-time images inside the mother’s womb, ultrasound technology is a go-to way for various specialists to deal with a wide range of diseases and tasks.

Let us take a closer look at how the emerging technologies of ultra-compact ultrasound, 3D and 4D ultrasound, artificial intelligence (AI), tissue harmonic imaging, and volumetric ultrasound are impacting the future of ultrasound imaging.

1. Ultra-Compact Ultrasound

Ultra-compact or portable ultrasound machines have taken imaging technology by storm. Previously, medical professionals had to use large, bulky, and complicated ultrasound machines for treating patients. Now, healthcare and clinical laboratories are opting for these ultra-compact imaging machines due to their portability and ease of use.

Portable ultrasound machines are also being used by healthcare specialists. In particular, portable ultrasound machines are useful in detecting UTIs. These machines offer a number of advantages over standard methods of UTI detection, such as computed tomography (CT) or magnetic resonance imaging (MRI). Portable ultrasound machines provide superior imaging quality and allow for real-time image guidance. These machines are perfect for primary care settings.

2. 3D And 4D Real-Time Ultrasound Imaging

The use of three-dimensional (3D) real-time imaging ultrasound technology is being driven by the demand for more accurate diagnostic images. This type of imaging provides a clear picture of the internal organs and can be used to detect abnormalities such as tumors. It is becoming more popular because it gives a better view of what is going on inside the body.

3D real-time imaging is becoming more popular for fetal ultrasound. This technology gives a more detailed view of the baby. This technology is new, and there is no standard protocol for its use yet. However, more hospitals are expected to start using this technology in the near future.

Further, this technology helps determine diseases with ease. It helps to achieve better visuals of human body organs. Compared to 2D imaging technology, 3D ultrasound imaging technology also takes less time.

Four-dimensional (4D) ultrasound imaging technology is even more convenient for healthcare specialists such as gynecologists. Compared to 3D ultrasound technology, 4D ultrasound shows live motion with the help of several images. With this technology, gynecologists can observe the live movement of the baby in the mother’s womb.

4D real-time ultrasound imaging provides a lot of benefits that traditional two-dimensional imaging does not, especially to gynecologists. This type of imaging gives a more complete view of the fetus, as well as showing how the fetus is developing over time. This technology can also be used to monitor multiple fetuses simultaneously. This is beneficial for high-risk pregnancies.

3. Artificial Intelligence

AI or artificial intelligence has a lot of potential in the medtech and imaging industry, including in the area of ultrasound technology. Ultrasound waves are used to create images of the inside of the body. This technology has been used for diagnostic purposes for many years. However, interpreting these images can be tricky, even for experienced radiologists. This is where AI comes in to help.

AI-enabled ultrasound machines can quickly and accurately interpret images. This can help doctors diagnose and treat patients faster. Additionally, AI can help identify patterns that human observers may miss. For example, AI can help identify early signs of several serious diseases, including cancer, heart disease, and stroke. This technology has the potential to save lives by providing earlier diagnosis and treatment.

4. Tissue Harmonic Imaging

Tissue harmonic imaging (THI) is another new emerging technology that's rapidly changing the use of standard ultrasound techniques. THI is an advanced technology that produces images with greater clarity than standard ultrasound. This means that clinicians can make more accurate diagnoses using THI, and this makes it particularly well-suited for use in cardiac imaging.

In addition, THI technology requires less power and can be performed more quickly, making it more convenient for both patients and clinicians. Further, THI is less likely than standard ultrasound to produce artifacts, which can often lead to inaccurate diagnoses

5. Volumetric Ultrasound

In general, volumetric imaging creates images of objects in space by combining multiple 2D images taken from different angles. This allows for a more complete view of an object than would be possible with just a single image. Now, the same concept is being used for medical diagnosis purposes.

Volumetric ultrasound provides 3D images of the body by steering a 2D array transducer in a scan format, using sound waves and computer algorithms to create images of the inside of the body. This imaging modality can be helpful in identifying cancer cells, tumor cells, and other abnormalities, as well as diagnosing various conditions, such as various heart diseases. Further, volumetric ultrasound is often used to help guide procedures such as biopsies and needle injections.

It is often used to image the fetus during pregnancy. It can also be used to image other organs and structures, as well as to assess relationships between different structures of human body organs. It is a great way to see small structures and is very clear.

Final Thought

Ultra-compact ultrasound, 3D and 4D ultrasound, artificial intelligence (AI), tissue harmonic imaging, and volumetric ultrasound are impacting – and will continue to impact -- the future of ultrasound technology, benefiting both healthcare providers and patients.

Education is the catalyst to increased adoption of handheld ultrasound

By Mustafa Hassan, AuntMinnie.com contributing writer

January 20, 2023

Handheld ultrasound has not yet reached mainstream adoption, but the worldwide market is still projected to reach over $500 million by 2026, according to Signify Research's newly published Handheld Ultrasound Deep Dive Report 2022.

In addition, market revenues are estimated to have grown by approximately 30% in 2021, driven by strong growth in the U.S., the biggest market for handheld ultrasound. Despite the global challenges for handheld ultrasound vendors in 2022, such as rising inflation and supply chain disruptions, the handheld ultrasound market is expected to experience double-digit growth, and this is forecast to continue through to 2026.

Most of the market growth will be fueled by increased adoption of handheld devices by new users of ultrasound, such as primary care physicians, nurses, emergency medical technicians (EMTs), and midwives. The key market trends are discussed below.

AI

The steep learning curve and subsequent ultrasound skills shortage are two of the biggest barriers to the wider use of ultrasound. These challenges are exacerbated in handheld ultrasound, where there is a higher proportion of new and less experienced users compared with cart and compact ultrasound.

As the expansion of the handheld ultrasound market in the coming years is expected to be strongly driven by new user groups, this barrier will be greater than ever before. These barriers can be partially addressed by artificial intelligence (AI) solutions that guide users with positioning and moving the ultrasound probe.

To date, most image guidance AI solutions, such as those from Caption Health, UltraSight, and DESKi, are for cardiac scans. AI image guidance solutions will have a bigger impact when they can also be used for other clinical applications, making it easier for users such as nurses to use ultrasound during their rounds. Though this is starting to happen -- with image guidance AI solutions for the thyroid (developed by Medo.AI), women's health (developed by Pulsenmore), and vascular applications (developed by ThinkSono) -- it will take time, capital, and data to develop image capture support for other body areas. In the interim, we expect to see more anatomy labeling solutions to assist with image capture.

In addition to AI for image capture support, solutions for image analysis will make ultrasound more efficient for users. These applications need to be embraced by physicians, some of whom may be wary about the performance and limitations of AI.

For AI to be more widely used in handheld ultrasound, one of the main challenges that will need to be overcome is how the AI applications are paid for. The solutions need to be affordable to the customer, in line with the price paid for the scanner, yet still enable AI vendors and potential OEM partners to make a profit. Another challenge is validating the AI solutions, which can be costly. This is one of the main reasons for the lack of ultrasound AI adoption in China.

Teleultrasound

With education being the most significant barrier preventing the adoption of handheld ultrasound, teleultrasound can have a positive influence by connecting novice users with experienced experts. With ultrasound increasingly being taught as part of the curriculum at medical schools, a teleultrasound platform enables newly trained physicians to connect with an ultrasound expert to help them become more comfortable in using ultrasound in real-life cases and to get a second opinion on a diagnosis.

With the current backlog in patients requiring imaging and changes in reimbursement, there is a drive to move imaging to out-of-hospital settings, and teleultrasound platforms, along with other digital solutions, can play a role in facilitating this shift.

Table 1 “Teleultrasound solutions available in the handheld ultrasound market"

Diverging Business Models

During the early years of handheld ultrasound, most devices were purchased with a one-time payment (capital expenditure). This payment model is familiar and accepted by healthcare providers and enables vendors with a broad range of ultrasound systems to sell handheld scanners to their existing customer base as an "add on" with bundled deals.

More recently, the new breed of dedicated handheld ultrasound vendors, like Butterfly Network, Vave, and Clarius Mobile Health, have introduced subscription payment models. Due to the low cost of handheld ultrasound devices, with the global average selling price now down to around $4,000, vendors need large sales volumes to make a profit. This is a challenge as handheld ultrasound has not yet achieved mainstream adoption. As such, most dedicated handheld ultrasound vendors are not yet profitable.

Vendors are now seeking subscription revenue streams, either to replace the upfront payment for the device or to supplement the initial device purchase, to generate additional and recurring revenue. Vendors are now launching digital solutions that are chargeable add-on services, such as teleultrasound and AI applications. Moreover, the subscription model enables vendors to lower the initial cost of the device, opening the market to cost-sensitive customers, such as new users of ultrasound.

Competitive Analysis

The leading vendors of handheld ultrasound are Philips, Butterfly Network, GE HealthCare, and Clarius. The largest Chinese handheld ultrasound vendors are SonoStar, Youkey, and Stork Healthcare. These vendors are mostly focused on their domestic market, except for SonoStar which has had some limited success in Western Europe and the U.S.

While the market was initially dominated by vendors such as GE HealthCare and Philips with a full ultrasound product portfolio, dedicated handheld vendors are becoming increasingly prominent. Initially competing with other ultrasound system types, notably low-end compact systems, handheld ultrasound vendors are increasingly developing customer bases distinct from users of compact systems. This trend will increase as handheld ultrasound becomes more mainstream and is adopted by increasingly newer users of ultrasound in new use cases such as in plastic surgery and medical aesthetics.

Although the majority of handheld ultrasound sales are wired devices, accounting for around 75% of handheld ultrasound sales revenue in 2021, wireless handheld ultrasound devices are expected to dominate the market in the future. The current product mix of wired versus wireless devices in the market is due more to the supplier mix than customer need, as most vendors currently offer wired devices. Among the larger handheld ultrasound vendors, Butterfly Network and Philips only offer wired devices and GE Healthcare launched its first wireless device in 2021.

The Signify view

The outlook for the handheld ultrasound market is promising, with a projected 2021-2026 compound annual growth rate of 24.7%. Growth will be driven by existing ultrasound users, either to replace compact systems or as an adjunct to existing systems, as well as new users of ultrasound such as nurses, primary care physicians, and midwives. Some vendors are also promoting the use of handheld ultrasound to enable patients to self-scan in the home setting.

Primary care is forecast to be the fastest growing clinical application for handheld ultrasound, with growth propelled by increased adoption of handheld ultrasound by primary care physicians. It is estimated that the percentage of primary care physicians that use ultrasound is in the single digits in most countries. The lower cost and ultraportability of handheld scanners are expected to notably increase the use of ultrasound in primary care.

The use of ultrasound in plastic surgery and medical aesthetics to improve procedure safety, is expected to be one of the fastest emerging applications of handheld ultrasound, especially in Western Europe and the U.S. Ultrasound will increasingly be used by plastic surgeons to differentiate their practice and reassure customers of the safety of cosmetic procedures.

"Handheld Ultrasound Market Deep Dive" presents market dynamics, estimates, forecasts, competitive analysis and major drivers for the handheld ultrasound equipment market. It segments the market into 30 countries/regions and into the five main clinical applications; radiology, cardiology, women's health, point of care, and specialty markets, with these markets subsegmented into 24 clinical applications overall.

Mustafa Hassan is an analyst at Signify Research, an independent supplier of market intelligence and consultancy to the global healthcare technology industry. Signify's major coverage areas are healthcare IT, medical imaging, and digital health