The 2018 European Congress of Radiology (ECR) kicks off today in Vienna. ECR is one of the leading global events in radiology, and the congress will welcome nearly 27,000 attendees from over 140 countries. Three hundred exhibitors, 50 of which specialize in ultrasound, will display radiology equipment and products, and the largest international companies will host ‘Satellite Symposia’, company-sponsored educational sessions, during the congress. The symposia provide companies with a stage to highlight emerging trends and future innovations from an industry perspective. Ultrasound companies hosting a symposium this week are Canon, Carestream, GE Healthcare, Hitachi, Philips, Samsung, Siemens Healthineers, and Supersonic Imagine.
The on-show guide to the congress provides an outline for each Satellite Symposia and shows that ultrasound companies will focus on three technologies during the sessions—fusion imaging, contrast enhanced ultrasound (CEUS), and shearwave elastography. These technologies and their influence on the global ultrasound market are defined and discussed below:
- Fusion imaging, where ultrasound is used in conjunction with computed tomography (CT), magnetic resonance (MR), or positron emission tomography (PET), allows for real-time assessment of interventional procedures. Interventional radiology procedures were traditionally performed using computed tomography (CT) and x-ray, but increasing economic pressures and concerns regarding radiation dose have created demand for interventional radiology ultrasound systems. The minimally invasive surgeries made possible by fusion imaging offer great cost-benefits to healthcare providers by increasing patient safety and decreasing the length of hospital stays. Several ultrasound companies have released fusion ultrasound products in the last year, including Philips, Toshiba (now Canon), GE, and Hitachi. The prevalence of fusion imaging in the ECR Satellite Symposia shows that the industry is invested in this technology and expects interventional radiology to continue outpacing other clinical applications of ultrasound.
- CEUS involves the use of microbubble contrast agents in conjunction with ultrasound imaging to show tissue perfusion and blood flow. CEUS was first used in the 1990s, but the US Food and Drug Administration did not approve microbubble contrast agents until 2016. CEUS can be used for a variety of applications, from classifying liver lesions to evaluating arterial blood flow and it provides several benefits over contrast-enhanced CT and MRI. For example, CEUS is safer than contrast-enhanced CT and MRI because it does not expose patients to ionizing radiation and its contrast agents do not contain dyes. These traits make CEUS an appealing alternative for radiologists, especially since some gadolinium-based contrast agents for MRI contrast imaging were recently banned by the European Medicines Agency due to concerns that they leave toxic gadolinium deposits in the body. In addition to these safety benefits, CEUS is more cost-effective than contrast-enhanced CT and MRI because ultrasound systems are less expensive than CT and MRI systems, CEUS does not require anesthesia or sedation, and CEUS reduces the needs for redundant downstream diagnostic testing. As a bonus, the portability of ultrasound systems allows CEUS to be performed at the patient bedside. The decision by several ultrasound companies to highlight CEUS during ECR suggests this new technology will be at the forefront of ultrasound product development this year.
- Shearwave elastography ultrasound systems measure the velocity of shear waves to determine tissue stiffness, and these systems are becoming the new gold standard for assessing liver diseases and lesions. Biopsy is the current gold standard for assessing liver fibrosis and cirrhosis, but the procedure can be risky and poorly accepted by patients. Ultrasonic imaging of the liver is noninvasive and pain-free, and studies have shown that shearwave elastography can assess liver fibrosis equally or better than needle-guided biopsy. Despite these benefits, gastroenterology ultrasound is a new field, and its adoption in markets outside of North America and Western Europe is low. Performing ultrasound examinations of the liver using shearwave elastography requires a highly-skilled operator and advanced ultrasound equipment, which has prevented the application from taking off in emerging and immature ultrasound markets. Most of the top ultrasound companies sold shearwave elastography-capable systems in 2017, and its prevalence in the ECR program proves it will remain a top priority for ultrasound companies in 2018.
The emergence of technologies like fusion imaging, CEUS, and shearwave elastography is generating markets for non-traditional clinical applications including breast, gastroenterology, internal medicine, and interventional radiology ultrasound. Ultrasound companies are capitalizing on these exciting new fields through educational sessions like the ECR Satellite Symposia.
The ultrasound technology trends at ECR highlight the increasing functionality of ultrasound as a powerful diagnostic and treatment tool for an ever-expanding list of clinical applications. Moving forward, non-traditional ultrasound applications will remain at the epicenter of innovation and growth in developed ultrasound markets.