Guideline report. Medical ultrasound imaging: progress and opportunities

Utilization of medical ultrasound has expanded rapidly during the past several years. In 1988, sales of ultrasound equipment will approach $600 million, which is higher than any other individual imaging modality, including the most capital intensive, such as magnetic resonance imaging (MRI), computed tomography (CT), and cath lab angiography. This growth would have been difficult to predict previously, since ultrasound appeared to be a relatively mature imaging modality not too long ago. There are several reasons for this growth. Technological developments have been quite rapid; ultrasound has become easier to use, image quality has improved dramatically, and diagnostic accuracy has been enhanced. There has been a proliferation of new equipment at all ends of the price spectrum, allowing the user a wide choice in instrument performance, multi-function capabilities, and automated features to increase patient throughput. The DRG environment and the prospect for more pre-admission tests have also been a stimulus. Hospital buying activity has expanded, and many more ultrasound exams are now being conducted on an outpatient basis. Sales to freestanding imaging centers and individual physicians have similarly increased. The hospital user is willing to pay a large premium for advanced technical performance and is prepared to retire or replace older technology in less than three years. This replacement cycle is much shorter than the four to five year period which existed prior to 1985. By comparison, some of the more traditional imaging areas, such as radiology, have replacement rates of eight to ten years. The reason for early replacement is obvious. Ultrasound exams in hospitals generate revenues at a rate that justifies the purchase of the most advanced equipment. It also improves the referral rate and positions the hospital as a high quality provider. Even with low utilization rates, an ultrasound instrument can normally pay for itself in less than one year of regular use. Ultrasound is one of the safest and least invasive of any of the imaging modalities. It provides a high diagnostic yield relative to its cost. It is comfortable for the patient and can be performed in almost any setting. The equipment is mobile and is relatively easy to use for most examinations. All of these factors have encouraged its increased use. This report examines trends in the ultrasound field from both a technological and economic standpoint and should help end-users in understanding the potentials of this important imaging modality.