The Future of Ultrasound

Ultrasound represents one of the most dramatic advancements in modern day medical diagnostics. With roughly 60 million ultrasound scans performed in the US annually, its importance is obvious and technological advances have been significant and consistent. From the introduction of grey scale B-mode imaging in the early 70s, to Doppler 3D/4D scans, ultrasound now represents an invaluable tool in obstetrics, cardiology, emergency medicine and beyond. All of which begs the question, where is it going from here?

To that end, we called on our experts to give us their perceptions, and predictions on the future of ultrasound.

1. AI will have a significant role in improving access to healthcare

Dr. Mariam Moshiri, MD, MBA and Professor of Radiology at Emory University, believes that AI tools will have a significant role to play in improving access to healthcare. “New ultrasound patch technology will revolutionize the field by creating portable, AI-enabled ultrasound that can be applied anywhere on the body. The recent development of a cardiac patch that could transform ultrasound’s diagnostic value in cardiology is just one example.

“And the good news is that a patch device will most likely replace a limited echocardiogram which already has a payment code, ensuring reimbursement,” says Dr. Moshiri.

While AI currently assists in acquiring images, results are still interpreted by specialists. But future developments might well automate analysis and interpretation, reducing the need for specialized operators, and significantly improving patient access to point-of-care diagnostics in various settings. 

Dr. Moshiri asserts that “ultrasound home monitoring and continuous data transmission made possible by new patch technology is promising. Together with the ability of healthcare systems to accurately evaluate AI-assisted imaging based on improved patient throughput, turnaround times and accuracy, the cost/benefit ratio of next generation ultrasound is definitely positive.”

2. The future of ultrasound is portable, affordable, intelligent, and increasingly operator independent

Carlos Gerardo, Ph.D., is the Director of R&D at Sonus Microsystems and he believes that the future of medical ultrasound lies in transforming how it is used, and who can access it. “I envision flexible, conformable probes that adapt to the natural curvature of the body and enable true volumetric imaging without requiring precise positioning or specialized training,” says Gerardo.

Advances in reconstruction algorithms will allow devices to compensate for anatomical obstacles and automatically optimize image acquisition, reducing reliance on the operator while making ultrasound more intuitive and accessible. Lower cost electronics and scalable manufacturing will expand access globally and open the door to safe, high quality ultrasound use beyond hospitals for quantitative assessments such as cardiac function or bladder volume. Complementary imaging methods will also enable co-registration and multimodality diagnostics that will improve accuracy in areas such as breast imaging and interventional care. 

3. Wearable devices will widen the scope of ultrasound.

Robert Rohling, Ph.D., is the Director of the Institute of Computing, Information and Cognitive Systems and a professor at the University of British Columbia. He envisions ultrasound as a wireless, lightweight, fully-integrated miniature device that produces large amounts of high quality diagnostic data.  

“There has been tremendous progress made in making ultrasound-specific electronics lighter, smaller and energy efficient. This advanced hardware, when combined with efficient ultrasound transducers, offers the opportunity to create self-contained battery-powered devices that perform all signal and image processing steps internally. The output is high quality ultrasound data that is rich in clinical information obtained over hours of operation. For example, cardiac output and ejection fraction could be obtained in real-time by simply sticking a thin ultrasound patch on the chest. This means all members of the care team could acquire and act upon these measurements wherever and whenever needed. Moreover, the collection of large continuous datasets leads to greater insight into a health condition. This would open up ultrasound to a huge new range of uses,” says Rohling. 

4. Autonomous operation will reduce bottlenecks in diagnostic imaging.

Dr. Sanjiv Bhalla, MD, FRCPC (Radiology) CCFP - EM, Co-Founder and Medical Director of Kinetix Medicine and a radiologist at Surrey Memorial hospital envisions wearable ultrasound, made possible by a patch-like device that removes the traditional barriers of cost and limited operator availability. 

“Key to its accessibility would be its ability to function without a dedicated ultrasound technologist, which is currently a major bottleneck in diagnostic imaging,” says Dr. Bhalla.

A patient could simply place the device on their body, and it would then retrieve information and send it to a processing center. AI would step in to provide information, or even suggest diagnostic insights. That data would then be sent to their physician or the EMR, and simultaneously to the patient's smartphone providing immediate feedback on what is, or isn’t happening. Real-time engagement of the patient is empowering, and will likely increase their personal involvement in managing their condition.

“It would be amazing to have an ‘always on’ ultrasound device that would catch pathology in the pre-symptomatic phase so that solutions, assessments or therapy could take place before negative outcomes happen,” continues Dr. Bhalla. 

By disseminating inexpensive, high-tech diagnostics across a broader population, the standard of care is elevated for everyone. And this means the future of ultrasound may well be a significant step toward the democratization of healthcare.

5. High performance applications will be made possible with both wearable, and ultra-miniaturized sensors. 

Hani Eskandari, Ph.D., CEO of Sonus Microsystems, has committed years to exploring both the legacy and limitations of conventional ultrasound. “For roughly 80 years, piezo-ceramic (PZT) materials have dominated the development of ultrasound technology, resulting in incremental improvements in both image resolution and depth. But conventional ultrasound image quality has reached a point of diminishing returns. PZT crystals are hitting fundamental limits regarding functionality, performance and form factor.” 

Eskandari points to the shift in market dynamics with the growth of emerging, high performance applications made possible with both wearable, and ultra-miniaturized sensors. Applications such as intravascular, intracardiac, or trans-esophageal ultrasound procedures, are becoming more streamlined with new disposable, catheter-based sensors. 

“For wearable applications, patch-based imaging enables the shift toward remote care and continuous patient monitoring. It also overcomes the primary bottleneck of operator dependency, through AI agents acting as the bridge for untrained users and providing real-time feedback on placement, enabling remote and decentralized diagnostic care.

“The next-generation technology will move past PZT, and towards advanced microfabrication, MEMS and polymer sensors that can be produced with high performance, high yield and at low cost. This will unlock numerous novel applications in ultrasound that are not feasible with the current status-quo technology,” says Eskandari.

The future promises more accessible and more real-time diagnostics

All signs point to the next generation of ultrasound offering more accessible and more informative real-time diagnostics. Innovation and technological advances have already overcome significant barriers, bringing the numerous benefits of flexible, wearable ultrasound well within reach. 

Considering the substantial issues of cost, accuracy and timeliness affecting patient care today, the future of ultrasound can’t come soon enough.