What are the future development trends of ultrasound imaging diagnostic equipment?

Ultrasound imaging diagnostic technology has been developed in China for about 60 years. With the continuous expansion of Applications and the continuous improvement of technology level, the demand for ultrasound diagnostic equipment has maintained a good growth trend.From analog signals to digital signalsFrom blackand white ultrasound to color Doppler ultrasound, from harmonic imaging to elasticity imaging, from manual identification to artificial intelligence,New functions and Applications are continuously expanding, and ultrasound imaging diagnostic equipment is constantly innovating and breaking through.

1  Basic Concepts of Ultrasound Diagnostic Technology

Because ultrasound diagnostic technology is a non-invasive, non-interventional, economical, practical, repeatable, and widely adaptable examination method, its Applications are extensive. Today, ultrasound examination instruments have become mainstream medical imaging equipment, especially the "B-ultrasound" system centered on ultrasound imaging technology has become a commonly used medical examination method. With the continuous expansion of Applications and the continuous improvement of technology level, the demand for ultrasound diagnostic equipment has maintained a good growth trend.

Ultrasound examination technology is divided into traditional  A-ultrasound (one-dimensional ultrasound)B-ultrasound (two-dimensional ultrasound)、Three-dimensional ultrasound and four-dimensional ultrasound。

B-ultrasound utilizes the physical properties of ultrasound reflection and refraction in human tissues. By using specific instruments to receive signals, it displays the morphology of various organs to determine the location, nature, and even the degree of functional damage of lesions. The commonly used term "B-ultrasound" actually refers to black and white two-dimensional B-ultrasound, which is a planar ultrasound containing only length and width. The collected images are individual black and white two-dimensional planes. We observe the tissue structure of the fetus and detect the placenta and amniotic fluid through these black and white photos. Color Doppler ultrasound, also known as color ultrasound, is high-definition B-ultrasound plus color Doppler.

Three-dimensional and four-dimensional ultrasound, in simple terms, are based on B-ultrasound but provide clearer images; four-dimensional ultrasound can determine the sex.

Compared to CT, MRI, X-rays, and Others detection methods, ultrasound diagnosis hasReal-time scanning (except MRI), non-invasiveness (except MRI), no radiation (except MRI), relatively low Price, mobile equipment, and flexible scanning methodsAdvantages.

Generally, medical ultrasound equipment can be divided intoBlack and white ultrasound equipment, color ultrasound imaging equipment, ultrasound endoscope equipment, and portable ultrasound imaging equipmentCurrently,Portable/handheld ultrasound imaging equipment is becoming increasingly popularThe portability of the equipment can greatly improve diagnostic efficiency, allowing doctors to use it freely in both large hospitals and remote clinics.

The left side is atable-top ultrasound device, and the right side is a portable ultrasound device

2  Overview of the International Market for Ultrasound Diagnostic Equipment

Globally, over 100 ultrasound manufacturers offer more than 500 different types of ultrasound equipment. According to IHS statistics, Europe, the United States, and Japan are the major ultrasound markets, accounting for a total of 70%, with advanced color Doppler ultrasound widely used in developed countries. The international market is mainly monopolized byGE, Philips, Toshiba, and Hitachiand other international giants, which occupy the vast majority of the mid-to-high-end color Doppler ultrasound market. Among them,European and American ultrasound dominates the high-end market, while Japanese and Korean ultrasound focuses on the mid-range market。

(Data source: HIS, where Mindray and CHISON are domestic Brands)

According to the survey,All the above companies have developed portable ultrasound instrumentsThis shows that portable ultrasound diagnostic instruments are bound to be the future development trend of the ultrasound equipment industry. Improved portability enables the use of these devices in remote Applications where reliable power is unavailable, such asClinical medical care in remote villages, emergency medical services, large animal husbandry, and inspection of bridges, large machinery, and oil pipelines.。

In fact, for decades, two-dimensional ultrasound has been the primary ultrasound examination method, and the development of basic ultrasound technology has been almost stagnant. However, in recent years, due to the emergence of new methods and concepts, ultrasound has made breakthroughs in practical technologies. Artificial intelligence has become a key research and development area for foreign ultrasound companies. The combination of the Internet and telemedicine may also lead the ultrasound industry to break into new areas.

3  Overview of the Domestic Market for Ultrasound Diagnostic Equipment

Domestic ultrasound has gone through three major stages: The first stage wasThe black and white ultrasound era(1960s); the second stage wasThe color Doppler ultrasound era(1980s); the third stage isThe functional diagnosis erawhich is also the current stage of ultrasound development.

(Data source: Medical Device Home)

The main consumer group in the domestic ultrasound market isMajor hospitals and medical institutionsTertiary hospitals, due to ample funding, have always been the primary target for imported ultrasound brands. In recent years, domestic ultrasound imaging manufacturers have emerged, gradually occupying the main market in domestic hospitals due to their advantages such as cost-effectiveness. Excellent domestic brands such as Mindray and Chison have launched mid-to-high-end ultrasound machines, and are competitive in the mid-range market. Last year, overall, the installation volume of domestic ultrasound equipment showed an upward trend.Exports of color ultrasound increased by approximately 5% year-on-year.。

In addition to significant technological advancements,the remarkable achievements in the research and development and application promotion of domestic ultrasound equipment benefit from government support.Medical imaging equipment is listed as“The 13th Five-Year Plan for Science and Technology Innovation in Health and Health”(jointly issued by multiple ministries and commissions), the Ministry of Science and Technology“The 13th Five-Year Plan for Science and Technology Innovation in Medical Devices”and the National Development and Reform Commission“Three-Year Action Plan to Enhance the Core Competitiveness of Manufacturing (2018-2020)”a key support project; the National Health and Family Planning Commission issued in May 2016 “Basic Standards and Recommended Standards for Medical Service Capacity of County Hospitals”which requires county hospitals to equip CT, MRI, DSA, and various types of DR equipment and ultrasound imaging equipment; from 2016-2017, “Digital Diagnosis and Treatment Equipment Research and Development” became a national key research and development plan.

Therefore, under the favorable policy situation, domestic ultrasound companies have sprung up. Last year, Shenzhen Mindray acquired the US company Zonare, and the Italian company Esaote was also acquired by another Chinese company. In addition, well-known companies include Shenzhen Chison, Shantou Ultrasound, Shenyang Neusoft, Shenzhen Weilder, etc. Most of the industry giants have begun to occupy the portable ultrasound instrument market.This article has a comparison table of domestic mainstream portable ultrasound product brands at the end.。

The figure shows a clinical image of the “Four-Leaf Clover” portable color ultrasound from Shenzhen Huasheng Medical.

The survey found that among well-known domestic ultrasound companies,Shenzhenaccounts for the vast majority of companies. Most of these companies were established relatively early, so most of the ultrasound products they developed are the first in the country. Some companies (Lan Yun) have relocated from Guangzhou to Shenzhen, aiming at Shenzhen's abundant ultrasound resources. There are also companies (Weilder) that started as OEMs (Original Equipment Manufacturers).

In the subsequent survey of ultrasound manufacturers in Shenzhen, in addition to influential brand manufacturers, we found that there are many small ultrasound equipment manufacturers in Shenzhen, widely distributed in Longgang, Pingshan, Bao'an and other areas. Due to their limited scale, these small ultrasound equipment manufacturers mostly produce medical consumables or related parts and accessories for ultrasound equipment, or provide equipment maintenance services. Many of them have cooperation with well-known domestic and foreign ultrasound brands (undisclosed), and the cooperation is mostly OEM (designated production). In addition to this model, ODMs (Original Design Manufacturers) that can manufacture complete machines or have independent R&D capabilities will choose to cooperate with local (or second and third-tier cities) medical institutions.

At the same time, we also found that some manufacturers, such as Shenzhen Anke (established in 1986), have difficulties in sales, and their website has a special section for finding agents and distributors.

Four  Future Trends of Ultrasound Diagnostic Equipment

With the rise of domestic ultrasound instruments and the narrowing gap with advanced foreign equipment, the procurement volume of domestic color ultrasound by tertiary hospitals has increased year by year. Currently, medical institutions below secondary grade A hospitals in China generally no longer equip imported color ultrasound instruments. The clinical application of ultrasound equipment will show the following development trends:

• Multi-functional whole-body machines may be gradually replaced.Because various specialized ultrasound instruments are not completely identical in terms of probe size, shape, frequency, and operation methods, whole-body color ultrasound will develop towards specialized color ultrasound.

• Application extension.Ultrasound medical technology is developing rapidly, such as elastography, contrast-enhanced ultrasound, and navigator fusion. These new technologies have strong integration and are integrated with ultrasound-guided intervention, bringing revolutionary changes to ultrasound medicine and broadening the application prospects of medical ultrasound equipment.

• Combination with artificial intelligence.Due to the lack of standardized ultrasound image acquisition, image quality control, and transmission standards in ultrasound medical examinations, it is currently difficult to conduct large-scale remote reading of ultrasound medical diagnoses. Therefore, using artificial intelligence assistance on ultrasound equipment to help primary-level doctors solve diagnostic problems in real time is an effective way to alleviate the uneven level and shortage of primary-level medical experts, and to promote tiered diagnosis and treatment.

• Portable/handheld ultrasound will be widely used.As mentioned earlier, portable ultrasound is increasingly needed and recognized by medical institutions due to its portability, low power consumption, high performance, and ease of operation. In particular, China's medical resources are unevenly distributed, and primary hospitals and township health centers are unable to purchase large-scale ultrasound equipment. Portable ultrasound will be a suitable and widely used alternative.

New technologies are constantly developing, and each technological change will bring opportunities for overtaking on curves. Overall, the market development of ultrasound instruments will be dominated by multi-functional color ultrasound, and the demand for portable and handheld color ultrasound is increasing rapidly. Domestic market demand is still being released, and future demand will continue to grow. Although domestic equipment has completed import substitution, there is still considerable room for expansion in the mid-to-high-end market, which may be a direction for the expansion of domestic brands in the future.

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