Ultrasound is more accessible than ever; the utility of ultrasound extends across the entire continuum of care and has become fundamental to providing cost-effective care for patients. Due to its lower cost, best imaging quality, workflow efficiency, reliability, no requirement of same computing power, fast frame rates, or specialized transducers ultrasound scans are becoming the preferred diagnostic imaging technique. Though ultrasound originated within traditional imaging, novel point-of-care (PoC) applications are now being performed by multiple specialties and are contributing to better patient care pathways that are safer and more economical than traditional imaging.
In the last couple of years, there has been a big investment in ultrasound productivity. A lot of new software technology and changes in the way companies are analyzing ultrasound information can be seen. Systems are being redesigned to be more streamlined, lighter, have less components, be user-friendly, and most of all, have much greater mobility. There really has been a proliferation of advancements over the last few years. Some other factors to highlight would be the creation of handheld ultrasound equipment and the adaptation of 3D and 4D ultrasound system capabilities. Also, image quality has vastly improved due to technology advances in transducer sensitivity. Previously, machines were only able to capture a single image, but now they are able to capture images through multiple planes simultaneously allowing for a more complete picture.
Furthermore, there is a progressive refinement in ultrasound technologies from trolley/cart based equipment to modern handheld miniaturized, wireless, and mobile machines with high portability, advanced computational power, workflow automation and improved quality, and networking capabilities. Over the years, the speed, efficacy, cost-effectiveness, and noninvasive nature of ultrasound imaging diagnostic capabilities have spread its usage across all clinical applications, from obstetrics and gynecology, orthopedics and cardiology to emergency medicine, prostate cancer, and breast cancer detection, and so on. TB is another sickness that can be successfully determined using ultrasound systems, additionally boosting its request. However, the industry might face little hindrances owing to the difficulty associated with the operation of these devices. Thus, researchers are focusing on making them technologically advanced enough to suit everyone’s purpose.
In 2017, Indian ultrasound equipment market is estimated at Rs. 1310 crore, an 8 percent increase over Rs. 1212 crore clocked in 2016. While the premium, very expensive machines saw a decline in market share, all the other segments including high-end, mid-end, entry level, and portable machines gained market share. The B/W are gradually losing share, and are only procured by small clinics, which do the preliminary test and then if required refer the patient to a nearby diagnostic center for further investigation.
Customer preference is shifting toward high-end technology and high quality imaging for better clinical diagnosis. The market for intraoperative ultrasound (IOUS) is rapidly growing and these ultrasound machines are preferred for various clinical scenarios like robotic surgeries, oncology, surgical gastro applications etc. Hospitals prefer dedicated IOUS machines that are compatible with common disinfectant methods, for safe use in the operating room. The market for high-end portable ultrasound too is seeing rapid growth because of preferences for high technology machines with superior image quality and easy workflow features like touch screen display monitors and high end probes.
The two largest segments for ultrasound tests conducted in 2017 were OB/GYN and radiology. Radiology was the first area to use ultrasound equipment intensively. Due to the large number of important applications, cardiology has also become a traditional setting for the use of ultrasound devices.
Some customers in 2017 include the Apollo chain of hospitals; AIIMS; PGI, Chandigarh; North Eastern Indira Gandhi Regional Institute of Health & Medical Sciences (NEIGRIHMS), Shillong; Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGI), Lucknow; Tamil Nadu Medical Services Corporation Limited (TNMSC); Govt. of Karnataka; KIMS Hospitals, Hyderabad; Amrita Institute of Medical Sciences, Kochi; Dr Mukund Joshi, Mumbai; and RP Scans, Chennai.
GE maintains its leadership by far. Other leading brands in India continue to be Philips, Mindray, and Samsung. Also aggressive in this segment are Siemens, Trivitron (Aloka and Hitachi), Esaote, Sonosite, Toshiba, BPL, and Sonoscape. Recently, Cura Healthcare has forayed into the business of ultrasound equipment device.
The past couple of years have seen remarkable technological advancements hit the market. These innovations have not only made scanning easier for the end-users, but have taken image resolutions to the next level. With the advent of touch screens, man and machine interactions have become seamless and efficient. The new gesture control touch panels on some ultrasound systems have taken this touch interface one step further. Machines can now be controlled with gestures. Machine control becomes easier and scanning becomes more enjoyable.
Vendors have also introduced elastography, which improves ultrasound’s specificity by utilizing conventional ultrasound imaging to measure the compressibility and mechanical properties of a lesion. Since cancerous tumors tend to be stiffer than surrounding healthy tissue or cysts, a more compressible lesion on elastography is less likely to be malignant. Elastography can properly identify lesions that appear to be malignant on a biopsy, as well as lesions that are benign. Elastography also can be more accurate in gauging the size of the lesions.
The global market for ultrasound equipment is expected to witness a CAGR of 5.8 percent between 2017 and 2023, to rise from a value of USD 7.9 billion in 2017 to USD 11 billion in 2023, projects Transparency Market Research. Rising population with chronic and lifestyle disorders; increasing public–private investments, funds, and grants; growing number of manufacturers for ultrasonic devices; and increasing adoption of ultrasound imaging in the field of cardiology, oncology, and emergency medicine are the main factors driving the growth of this market.
Moreover, technological shift from conventional to PoC ultrasound diagnosis, increasing adaptation of ultrasound systems in hospitals and diagnostic centers, and growing penetration of ultrasound equipment manufacturers in emerging nations are some of the factors that are further propelling the growth of the market. However lack of skilled sonographers, stringent regulations and legislations, high cost of medical imaging, and cost associated with the recalibration of these devices are few major aspects that are hampering the growth of the global market.
Geographical area wise, Europe is the largest market. However, the market is expected to witness a paradigm shift with Asia-Pacific taking over the market giant and replacing it to be the leading region in the global market by the end of 2023, growing at a CAGR of 6.5 percent, suggesting an array of opportunities for growth and likely to be getting into the eyes of new investors in the market.
The market is highly consolidated and all the existing players are involved in developing new and advanced products to maintain their market shares. Recently, Clarius Mobile Health has launched wireless handheld ultrasound scanners that will work as a stethoscope for doctors and help professionals to diagnose accurately.
Ultrasound systems have made several advances over the years with many more uses in the hospital setting. Enhancements in traditional ultrasound include contrast imaging, volume imaging, and elastography. These advances allow physicians to image blood perfusion and blood flow, view real-time 3D imaging of structures, and differentiate malignant tumors from benign, among other applications. Another important technological advance in ultrasound, however, is the development of mobile systems with increased functionality for the PoC market.
Mobile ultrasound probe. It is becoming an increasingly disruptive technology for the entire medical imaging industry. A wired or wireless probe can now display an ultrasound image on most off-the-shelf tablets or even smartphones. Image processing has come a long way allowing for the smaller, more mobile stand-alone probe to challenge its predecessor with the larger systems in most aspects including 3D and 4D imaging. The market has been picking up slowly as more and more skeptical providers are embracing portable systems. The technology has the potential to save the medical industry billions of dollars in healthcare cost as a portable probe is only a fraction of what the large cart-based system costs.
PoC ultrasound. Point-of-care ultrasound (PoCUS), while not exposing the patient to radiation, may facilitate early diagnosis and minimize the need for delay in management of patients with major health issues. There have been continual advances in PoCUS technology. This is helping to reduce hospital and patient expenses by decreasing costs to the health system and the time required for diagnosis and treatment. Because hand-carried POC systems are so much smaller than conventional cart-based systems – and because mountable POC machines have a zero footprint in locations where space is at a premium – PoCUS has also found its way into remote corners of the world where funds, facilities, and space are limited.
Image quality. The quality of image has improved exponentially in recent years with the addition of high definition also known as 4K resolution to monitors and LCD displays. Progressive p resolution has been proven to be faster, provide a clearer picture, and be less prone to blurring therefore allowing radiologists/cardiologists to calculate a much more defined diagnosis. The majority of advances came in miniaturization. A lot of systems became smaller and more compact and come with algorithms that help in image quality as well.
Transducer technology. There is a greater commitment to transducer innovations that allow clinicians to easily assess technically difficult patients, such as young children or individuals who are overweight. For instance, Philips’ PureWave technology is specifically designed to allow deep penetration and excellent resolution on all patients, even those who are traditionally harder to image. These portable devices improve the accessibility of ultrasound while streamlining diagnostic processes and improving quality of care for patients. This has led to wider adoption by a variety of providers who may not traditionally have used ultrasound, including nurses, midwives, and emergency medicine and critical care professionals.
Contrast media. Newer ultrasound contrast media materials facilitate higher levels of tissue absorption of therapeutic agents used in chemotherapy and the dramatic increase of handheld smartphone ultrasound devices, especially as it relates to point-of-care use on a worldwide basis. With the new materials, modalities, and techniques, as well as the creation of novel acoustic biomarkers, the blending of diagnostic ultrasound with therapeutic ultrasound is becoming more pronounced and will continue to dramatically evolve over the next 5 years.
AI and automation. The new systems feature capabilities such as precision imaging, differential tissue harmonics, and advanced dynamic flow. The systems are more intelligent than ever before, and that helps users to be more confident. Manufacturers are also introducing elements of artificial intelligence (AI) algorithms into their cardiac ultrasound systems to speed automation. It takes a 3-D echo dataset acquisition and automatically analyzes the image to identify the heart’s anatomy, labels it, and then slices the optimal standard views for presentation. Other vendors also have introduced elements of deep learning algorithms to help analyze echocardiograms or perform auto quantifications. Next-generation echo systems will incorporate more AI features to further improve workflow by auto-completing time-consuming tasks and augmenting the sonographer so they can become more efficient and consistently accurate.
Most therapeutic administrative and counseling bodies, including the WHO, concur that the quantity of patients experiencing cardiovascular ailments is developing at an alarmingly high rate. The WHO states that the quantity of heart patients is relied upon to cross 23 million by 2030 and is one of the leading mortality causing NCD in India. This is all that anyone could need to demonstrate that human services associations are in grave requirement for cutting edge ultrasound technology.
As technology evolves, the basic tools clinicians use to assess patients change as well. PoCUS has the potential to improve patient management for all medical and surgical subspecialties. In routine and urgent settings, using ultrasound imaging to help in the timely assessment and diagnosis of medical conditions is going to become more commonplace among general practitioners, critical care physicians, orthopedic surgeons, and anesthesiologists. It is expected that there will be continued advancements in ultrasound toward cost-effective solutions that do not compromise high-quality imaging. Ultrasound will become even more automated, mobile, definitive, and intuitive for users, making it an indispensable everyday tool for patient diagnosis and care in near future.