February 2010

The New Dimension in Ultrasound Scanning

Ultrasound technology has aided in the improvement of clinical outcomes by providing immediate and actionable clinical information at the point-of-care. The technology helps in reducing overall costs by replacing more expensive diagnostic exams. Divya Chawla examines the latest technological trends and application areas in this field.

The emergence of ultrasound modality as a medical imaging technique more than three decades ago marked the advent of an increasingly diversified market segment in the diagnostic market. Ever since, the diagnostic capabilities of ultrasound have grown beyond imagination, spanning a plethora of medical specialities such as obstetrics and gynaecology, orthopaedics, and cardiology, among others. In fact, in recent years ultrasound technology has proliferated beyond the confines of radiology and are being increasingly used by non-radiologists  for diagnostic purposes in a variety of clinical settings. The speed, safety and cost-effectiveness of ultrasound are some of the key features that give this technology an edge over the other imaging modalities, in addition to its ever increasing information density. Its uniqueness lies in its ability to use sound waves instead of ionizing radiations to image various structures in the human body. Around the world, ultrasound’s cost-effective imaging technology is eliminating the need for more expensive imaging modalities for carrying out diagnostic procedures.

The Fourth Dimension in Ultrasound

Advancements in technology leading to enhanced computing power of ultrasound equipment for complex signal processing tasks in recent past has now made it possible to obtain ultrasound images in three and four dimension. This technology marks the next-generation integrated solution for medical imaging allowing clinicians to provide faster treatment and improve therapeutic success rates. Leading ultrasound vendors have introduced ultrasound systems with 3D/4D capabilities that have revolutionized the imaging of unborn babies. One of the 4D ultrasound systems that have recently hit the market is GE’s Voluson 730 4D ultrasound scanners. Philips, a leader in medical technology, also offers systems that offer great performance and unmatched 4D  ultrasound imaging. Technological advancements have actually made it possible to view ultrasound images in the fourth dimension. There is no doubt that the technology holds much promise and augments the growth potential of the entire ultrasound market.

Miniaturization-The Latest Trend

Windows PC-based architecture and device miniaturization are making it possible to pack increasing amounts of processing power into smaller and smaller medical devices. The ultrasound device segment has also adopted this trend with the introduction of laptop-size, hand-carried ultrasound systems. The increasing focus on ergonomics has augmented the miniaturisation of ultrasound systems. Further, the rapid advancement in  software and semiconductor technologies coupled with  no need for bulky lead shielding, miniaturization of ultrasound equipment provides lesser challenges and difficulties.

Currently, one of the fastest growing segments in the ultrasound equipment market, hand-carried ultrasounds are growing at an explosive pace and are becoming increasingly popular among clinicians throughout the world.  The need of the hour is premium quality imaging at the point-of-care and integration of advanced technologies is making these systems more widely acceptable by clinicians. The major attraction for end-users include improved technology, offers diagnostic-quality images, longer battery life and better tissue penetration. The more obvious benefit of hand-carried ultrasound systems-their role in time saving-is another factor that continues to drive its growth.

In addition to the already established players in this segment, such as SonoSite, a number of other players, both big and small, have also included hand-carried portable ultrasound systems in their product portfolio. Physicians report that newer ultrasound systems offer excellent performance and great portability, which eliminates the need for investing in a separate ultrasound system for each location. As a result, radiology departments, across the world, are replacing their traditional cart-based systems with latest hand-carried ultrasound equipment that are capable of docking to accessory carts to become pseudo-cart-based systems.

Ultrasound and Liver Elastography

The latest liver elastography technology, introduced in India by Siemens Ltd., holds huge potential in terms of detecting liver diseases at an early stage. State-of-the-art ultrasound scanners can examine tissue elasticity in real-time offering the clinicians with the intricate details required to study various liver diseases including liver tumours, such as those causing cirrhosis. In addition to differentiating between malignant and benign tumours, the technology can also be used to detect breast cancers.

Though falling in the high-end category, the technology is expected to reduce the overall procedural and treatment costs. As the technology proliferates, the costs are required to fall further making the technique more economical and cost-effective. In fact, in future, the technology is expected to be a major factor that will drive sales of ultrasound equipment installed with software that are compatible with this technology.

Dr. Bharat Aggarwal
Strategic Business Development,
Diversification and IT Diwan Chand Satyapal Aggarwal Imaging Research Centre


Please tell us about the ultrasound machines that are currently installed at Diwan Chand Satyapal Aggarwal Imaging Research Centre?

Currently we have three colour Doppler machines, two from Siemens and one from Philips. All these are high-end colour Doppler multi-purpose machines with all applications.

Have you installed any systems that offer 4D imaging?

We are looking at doing some amount of 4D ultrasound scanning. The technology has value add features in some areas of specialization, thus offering enhanced imaging. We are upgrading to newer machines with 4D technology and automated acquisition techniques, which have recently been introduced by Siemens and GE.

What is the scope of hand-held ultrasound systems?

Hand-held ultrasound is going to be an important tool for gastroenterologists as instead of palpating the liver they can easily use the hand-held machine to view the liver. It can also be used by the gynaecologist to have a look at the uterus. A drawback, however, is that it has poor resolution and a back-up high resolution traditional ultrasound system will always be required by any facility that is using hand-held systems. The hand-held system can act like an extended diagnostic tool, which is readily available with the clinician.

Which are the other latest technologies in the ultrasound sector?

A lot of IT vendors are developing technologies to see ultrasound images on PDAs. However, these images cannot be used for diagnostic purposes because of offering smaller-sized images and lower resolutions. Hence, PDAs can be used for viewing and advising purposes but not for diagnosis. Another technology that we are keenly looking at is ultrasound elastography- both liver and breast. Another important area is ultrasound contrast media, even though it is expensive.

The Road Ahead

Development of sophisticated software and novel analytical methods to interpret data has completely transformed ultrasound technology in recent years. An ageing population with increased incidences of aneurysms and osteoporosis, cardiovascular diseases, and the like are some of the key factors driving growth in this segment. Three major areas identified for higher growth include- hand-carried ultrasound systems, proliferation of ultrasound technology in a gamut of medical specialities other than obstetrics and gynaecology, and adoption of ultrasound by new user groups including surgeons, anaesthesiologists, and emergency physicians. Vendors, across the globe, are pioneering new and innovative technologies for varied applications such as cardiac imaging and 4D neonatal imaging, leading to emergence of unlimited medical applications of ultrasound. Trends in this sector are changing every season with development of portable ultrasound machines and real-time image viewing. With so much happening, it would be unfair to underestimate the growth in this sector the future definitely has scope for an explosive growth in the ultrasound market.

vendor

Product Details

Blue Star (Hitachi Medical Systems)

Hitachi Medical Systems offers modern ultrasound scanners with ergonomic features for various clinical applications. Hitachi has also added real-time tissue elastography technology in its ultrasound product range.

Chayagraphics (Wipro GE Medical Systems)

A Bangalore-based company, Chayagraphics is an authorised channel partner for Wipro GE Medical Systems. Its range of products in the ultrasound segment range from basic black and white systems to 4D colour Dopplers.

Esaote India

Esaote India offers the MyLab range and Aquila Pro colour Doppler ultrasound scanners for a range of clinical specialities including cardiology, radiology, vascular, obstetrics and gynaecology and for various other dedicated applications.

GE Healthcare

GE Healthcare has introduced breakthrough technologies in the ultrasound segment with its Logiq, Vivid and Voluson product families. In addition, it offers powerful IT applications to support these technologies.

L&T Medical

L&T Medical offers Scintila colour Doppler system for multi-speciality applications and black and white ultrasound scanners.

Medion Healthcare
(SonoScape)

Medion brings to India a range of high-end ultrasound systems from SonoScape. These include an entire range of black and white and coloured systems offering extended applications in a variety of clinical procedures.

Mindray

Mindray offers the DC range of coloured ultrasound scanners and the DP range of black and white systems. It has also forayed into laptop-sized ultrasound systems with the launch of its M5 ultrasound scanner.

Philips Medical Systems

Philips’ ultrasound systems span the entire arena-cardiology, emergency medicine, general imaging, regional anaesthesia, vascular, women’s healthcare, and more. It also offers a range of transducers for all applications and ultrasound systems.

Sanrad (Zonare)

Sanrad represents Zonare in the ultrasound systems market space in India. With this Sanrad brings to India the advanced z.one sonography technology offered by Zonare.

Shimadzu

Shimadzu, in India, offers both black and white scanners and colour Dopplers under its SDU range. The Sarano ultrasound system offered by the company encompasses advanced technologies for professional-level clinical diagnosis.

Siemens Medical

Siemens offers the complete range of ultrasound systems. In addition, It is first in India to provide a comprehensive suite of Tissue Strain applications that provides a new dimension of diagnostic information of the mechanical stiffness of tissue.

SonoSIte

SonoSite one of the leaders in hand-carried ultrasound systems, offers a broad range of products in this category. Its latest product the NanoMaxx is extremely portable and tough, suited for high resolution imaging and procedural guidance.

Toshiba (Erbis)

Toshiba, has been at the forefront of ultrasound imaging by introducing new applications and setting world-class standards that have extended ultrasound capabilities. The company offers and array of products in this segment.

Trivitron (Aloka, Japan)

Trivitron offers black and white ultrasound systems and colour Dopplers from Aloka, Japan. It also offers the Terason range of laptop ultrasound systems in India

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