IHS Markit recently published its Ultrasound Clinical Applications Report which analyzes the global market for 20 ultrasound clinical applications. The following table shows the market size and forecast for traditional applications (which comprises cardiology, OB/GYN, and radiology), non-traditional applications, and point-of-care applications:
Radiology remains the largest clinical application, but the global ultrasound market is evolving as it grows, and non-traditional and point-of-care applications are now at the forefront of product development. In 2017, cardiology ultrasound growth outpaced other traditional applications and technology development boosted the non-traditional and point-of-care ultrasound markets. Primary care remained a major emphasis for manufacturers and end-users.
Traditional applications are here to stay
In 2017, the global market for ultrasound was dominated by traditional applications. This segment’s revenue grew more than the market average and totaled $4.5 billion in 2017. Segment growth was driven by strong demand for traditional equipment in China and in emerging markets in Asia Pacific, Latin America, and the Middle East.
Cardiology ultrasound growth outpaced other traditional applications, driven by demand from the developed markets of North America and Western Europe. There are several reasons for this growth in the cardiology market:
- The migration of sophisticated software from the niche premium price bracket to the broader high-end price bracket has increased the affordability of advanced cardiology technologies and increased cardiology revenues because more healthcare providers can afford advanced systems.
- The growing market for ultrasound has made specialized equipment more accessible to healthcare providers, so more departments, including cardiology departments, are buying their own ultrasound equipment.
- The number of cardiology ultrasound examinations performed each year have steadily increased in Western Europe and North America. As cardiologists have become more dependent on ultrasound, the demand for their own equipment has also risen.
Non-traditional applications are not so non-traditional anymore
The non-traditional segment continued to grow and revenues increased 5% from 2016 to 2017. Interventional cardiology, surgery, and interventional radiology unit shipments grew the most year-over-year. The development of shearwave elastography, fusion imaging, and contrast-enhanced ultrasound (CEUS) technologies boosted the non-traditional market in 2017. These technologies are enhancing the clinical power and relevance of ultrasound.
- Shearwave elastography ultrasound systems measure the velocity of shear waves to determine tissue stiffness. Shearwave elastography is enhancing breast ultrasound’s usefulness to diagnose and stage breast cancers, by providing diagnostic information about breast tissue stiffness. Shearwave elastography is also changing the way doctors diagnose liver lesions. Ultrasonic imaging of the liver is noninvasive and pain-free. Studies have shown that shearwave elastography can assess liver fibrosis as well or better than needle-guided biopsy. In the internal medicine field, shearwave elastography is improving the diagnostic accuracy of thyroid ultrasound by quantifying thyroid nodule stiffness.
- Fusion imaging, where ultrasound is used in conjunction with CT, magnetic resonance (MR), or positron emission tomography (PET), allows for real-time assessment of interventional procedures. This technology is a key driver for the interventional radiology market. Minimally invasive surgeries performed using interventional radiology ultrasound and fusion imaging offer great cost-benefits to healthcare providers by increasing patient safety and decreasing the length of hospital stays.
- CEUS involves the use of microbubble contrast agents in conjunction with ultrasound imaging to show tissue perfusion and blood flow. It can help differentiate benign and malignant lesions which will play an important role in the technological advancement of breast, gastroenterology, and internal medicine applications. CEUS also increases the contrast between tissue and blood; an imaging feature that is crucial to cardiology ultrasound and holds promise for other clinical applications.
In addition to these technology trends, the increasing number of minimally invasive procedures drove demand for interventional cardiology and interventional radiology in 2017. Healthcare providers continued to be pressured to reduce surgical costs while improving patient outcomes. Ultrasound manufacturers have responded by launching several new interventional ultrasound products. The advanced products have made more minimally invasive procedures possible, encouraging the expansion of the interventional ultrasound applications market.
Point-of-care remains a point of focus
Point-of-care ultrasound, which consists of anesthesia, critical care, emergency medicine, musculoskeletal, and primary care applications, remained a major focus for manufacturers and end-users. Point-of-care was the smallest application segment in unit shipment terms, but it grew 14% from 2016 to 2017 – the highest year-over-year growth rate of all three application segments. The point-of-care segment is unique because it is heavily served by compact and handheld products. The number of these products on the market has rapidly grown during the past five years. As new products flood the market, competition is intensifying and driving prices downward.
The primary care market drove segment growth due to increased awareness of this emerging clinical application. Primary care ultrasound equipment is used in a physician's office to quickly assess and diagnose patients at the point-of-care. Physicians have long desired the ability to quickly diagnose patients without referring them to a radiologist and waiting several days for the results, and the growing compact and handheld ultrasound market has finally made primary care ultrasound accessible and affordable. In 2017, the primary care market had the most new users of all clinical applications.
There are two schools of thought regarding primary care ultrasound: 1) Proponents of primary care ultrasound believe it will improve patient outcomes, provide physicians with more autonomy, and lead to more business for private clinics. 2) Others are more skeptical, questioning ultrasound’s ability to fit into the primary care workflow. Traditionally, primary care doctors do not focus on diagnostics and ultrasound systems could sit unused in primary care offices. IHS Markit believes the first opinion will win out and the primary care ultrasound market will expand during the next five years. Several countries are in the process of improving their primary care infrastructure, including the United States, China, and India, and this trend will drive growth for primary care ultrasound revenues through 2022. The increasing strain on hospital resources in countries like Japan will further encourage growth of primary care ultrasound by shifting medical imaging away from hospitals and into outpatient settings.
A full assessment of the global market for ultrasound clinical applications is available from IHS Markit in the Ultrasound Intelligence Service. This service offers regular quantitative and qualitative analyst insight, market share analysis and granular visibility into clinical applications. A deep-dive application database contains analysis of the global ultrasound market split by country, product and clinical application with 5-year forecasts. The ultrasound equipment database provides detailed revenue, unit shipment and ASP 5-year forecasts for 9 ultrasound product types in over 30 countries with market share provided at a sub-regional level for all product types.
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