Upping the tech edge in medical imaging

Express Healthcare reviews the potential of technology to revolutionise radiology and medical imaging, giving better patient outcomes and efficiencies

The medical imaging industry is undergoing rapid change due to acceleration in innovation, emergence of new business models with adaptation of technologies like artificial intelligence and the Internet of Things.

Over the years, this hasn’t been limited to the modalities through which images are acquired. There has been an increasing emphasis on more advanced ways of sharing and storing medical images. Moreover, clinicians can now manipulate images to gain greater insights and information from the same set of data. The technology adoption has generated large digitised data sets that can be subjected to advanced analytics and deep learning. Also, it can improvise the accuracy and speed of diagnostics, delivering measurable benefits in better patient care, reductions in costs and variability, and greater satisfaction for radiologists.

Talking about the rising trend of technology in radiology & imaging sector, Atantra Das Gupta, Director, HME Business, Samsung India said, “Advanced technology and groundbreaking innovations are constantly benefitting the healthcare sector and digital health and artificial intelligence will be the driving force for the radiology & imaging industry. The government of India has already indicated that healthcare will be an important part of their planning and budgeting. We shall see a surge in primary care home monitoring technologies, telecare technologies and diagnostic devices which means a huge scope for boom in this industry.”

Dr M L Bera, Head-Department of Radiology, HCMCT Manipal Hospital, Dwarka, New Delhi highlights that, “The practice of radiological services is undergoing rapid change in recent years due to technological advancement, workload escalation, workforce shortage, privatisation, corporatisation and globalisation of healthcare facilities. With more and more advanced cutting-edge technologies, now the radiological services have transformed into multiple sub-specialties both in diagnostic and therapeutic fields with a challenging future. This sudden proliferation of radiological services into multiple sub-specialties’ has led to newer innovations by manufacturing industries to meet the requirement of healthcare workers. This has drastically changed the outlook of the manufacturing units with great future ahead.”

Market scenario

As per a report by Grandview research, “The global medical imaging market size was valued at USD 15.9 billion in 2020 and is expected to expand at a compound annual growth rate (CAGR) of 5.2% from 2021 to 2028. Major factors driving the industry are the increasing demand for early-stage diagnosis of chronic disease and rising aging demographics, which is expected to boost the demand for diagnostic imaging across the globe. Technological advancements, coupled with supportive investments and funds by the government, especially in developing countries, such as India and China, are also expected to contribute to market growth.”

The report also highlights that, “countries such as Thailand, India, and South Korea have recently shown a surge in installing 3.5T MRI systems. Favorable FDI policies, increasing ease of doing business, and rising awareness of the advanced imaging technologies are some of the factors expected to fuel the overall market growth. The introduction of teleradiology services has enabled global networking of expertise. This is expected to overcome the problems related to the lack of expert radiologists in these countries. Asia Pacific diagnostic imaging market is anticipated to grow at the fastest rate over the forecast period owing to the rising incidences of chronic diseases and the high demand for advanced imaging devices. Recent trends of collaborations of local and global companies are expected to have a synergistic effect on market growth. Such collaboration and exchange of technologies help in speeding up the development and boost the market competition, thus providing sophisticated yet affordable imaging systems. Such collaborations are not limited to diagnostic imaging players. The integration of imaging modalities with advanced surgical suites manufacturers is expected to have a boosting effect on the diagnostic imaging market growth as well as robot-assisted surgery systems. “

The increasing demand for state-of-the-art imaging modalities by teaching hospitals and universities to provide training for advanced technology is expected to have a significant impact on the market growth during the upcoming years. This trend, previously limited to the developed countries, is now showing a shift towards developing countries as well.

A report by Morder Intelligence predicts that the India Diagnostic Imaging Equipment Market is to register a CAGR of 12.4% during the forecast period. The propelling factors for the growth of the Indian diagnostic imaging equipment market include the rise in the prevalence of chronic diseases, increased adoption of advanced technologies in medical imaging, and the growing geriatric population.

COVID19 impact on medical imaging market

Portable CT and X-ray systems were in huge demand during 2020 for faster assessment of COVID-19. The need for repeated optimisation is increasing the waiting period for scanning, Ultrasound devices were extremely used to differentiate COVID-19 and other respiratory diseases.

Grandview research predicts that in the post-COVID market, CT segment is expected to show more than 8% CAGR as compared to the previously calculated CAGR of 7.2% from 2021 to 2028. The increasing need for frequent chest imaging to monitor the long-term effects of COVID is expected to boost the demand for imaging modalities, especially in primary health centers.

Highlighting the impact of COVID-19 on the market, Dr Rajat Bhargava, Head of Department, Radiology, Fortis Hospital Mulund said, “There is tremendous growth in high-end imaging. Due to the COVID19 pandemic, there’s a massive demand for CT scans for public health and proper diagnosis. Hence, sales of CT scanners are also booming, leading to companies being unable to meet the demand. In the initial days of COVID19, MRI, which is at the highest level in imaging technology and in terms of expenditure, saw a slowdown. However, it is now witnessing growth again.”

Dr Pramod Dhembare, Founder and Managing Partner, Fidelity Diagnostics said, “With the emergence of COVID-19, a significant positive impact on the diagnostic imaging market was also observed. HRCT emerged as one of the primary tools for monitoring COVID-19 patients. Thus, this rising adoption of use of CT scanners is likely to augment the market growth.”

“Before the COVID-19 pandemic, diagnostic testing was generally used, as a tool to help medical doctors in diagnosing illness so that the patient could get further needed treatment. Our earlier pre-COVID system, by design, was largely responsive in nature: the patient went to a doctor after getting the symptoms, received a diagnosis, and then was treated. In post-COVID scenario, patients are now more aware of the diagnostic sector and the importance of diagnostic testing than they were before the pandemic. Testing will now also be used for more than the treatment of illnesses. Such awareness will change expectations of diagnostic testing and will attract new innovators to the industry. No longer will customers allow the industry not to deliver on 3 qualities, speed, precision and affordability. The industry must change to meet the changing needs of customers, or someone else will enter the market and do so. The diagnostics industry as we know it is going to change as a result of COVID. We can either be part of this change or be left behind”, he added

Emerging trends shaping the future of radiology & imaging

Over the recent decades, the abilities of medical imaging have thoroughly expanded. Because of basic exploration and mechanical development, there have been various progressions in medical imaging innovation. This advancement is pivotal in giving increasingly precise judgments and bettering patient consideration. Brushing these headways with its intensity and optimisation development additionally advances more noteworthy procedural proficiency in the arrangement and execution of patient consideration.

Some of the key technology to impact radiology sector includes big data analytics, artificial intelligence, extended reality, wearables, cloud, robotics & smart machines, 3D technology & printing blockchain, radiogenomics, imaging informatics, digital twin, 5G, biocomputing, brain computer interface, internet of things. While India is actively adopting and using most of them, technologies like wearables are still at a niche stage but looks promising.

Explaining about the penetration of wearables in Indian market, Arjun Arunachalam, Founder and CEO, Voxelgrids Innovations added, “Practically non-existent. At least within the domain we operate, there are no such practical devices available in the marketplace to the best of our knowledge. We see a future for anatomy-specific devices as well as for more mobile and portable devices. Pure wearable devices are not on the horizon as of now, primarily due to inherent limitations in the physics of the various imaging processes.”

Highlighting the acceptance and adoption of technology in the sector, Dr Sagar Tyagi, Attending Consultant, Interventional Radiology, Max Super Speciality Hospital, Shalimar Bagh added, “In India, new technologies arrive few years after they are launched abroad. Artificial intelligence is new to the radiology sector in India. Apart from few high-end centers, general adoption of technology in India usually is at a slow pace. Algorithms work as a support to the radiologist in making a better diagnosis, however, cannot replace the human power of decision making in healthcare. Nevertheless, new technologies continue to change the dynamics of imaging sector.”

 Talking about the emerging trends in the sector, Shantanu Thatte, Sr. Manager-Equipment Consulting, HOSMAC said, “With advancement in technology at such a rapid pace, more and more sophisticated and high modality equipment are emerging in to the domain of diagnostics and investigations. Early emerging trends that can be envisaged are on both the sides of a coin. Launch of equipment to the likes of PET-MR, MR-Linac, and proton therapy can be witnessed in metro cities whereas the stakeholders look to invest into low-cost segment cathlab in cardiology, a judicious gradual shift from 3 T to 1.5 T MRI, and to that of CT from 128 Slices to 16/32 slices can be witnessed mostly in tier 2/3 cities. Owing to the increase in the number of CT installation base in deep pockets of India, there will be a requirement for the tele-radiology services soon to assess the patient reports remotely.”

Praveen Rajgopal, Vice President-Medical Print business, Carestream highlighted, “The industry is currently at the crossroads with many complex inherent challenges. However, the current challenges are opening the doors for future innovation drivers coming from new players. These industry challengers are closing existing technology gaps by bringing in best practices from other industries changing the competitive landscape of the sector. Past breakthroughs on new imaging devices are being replaced by software developments focusing on integration and radiology workflow improvement.”

“Newer technological advancements such as artificial intelligence, machine learning, deep learning etc. are adding significant value to the field of radiology and imaging and helping radiologists in their workflow, diagnosis and decision process. These advances driven by many start-ups are promising to shape and transform the future of this field in a way which is soon going to change our world”, he added.

Potential of technology in the sector

Technological advancements in radiology sector have led to the changes in way radiologists work which is in turn is giving benefits to the patients as well.

Highlightening the importance of technology in radiology sector, Gupta said, “Radiology and Imaging is a technology-oriented sector. Innovation is a synonym of business here. Technical advancements have prompted changes in the radiology business in recent years and this benefits the radiologists and patients as well. These innovations permit doctors to deliver high-quality services. Every year we launch newer technologies in Ultrasound imaging and migrate the technology and features to lower segment machines. Faster processing and precise results are a huge advantage with the use of technology.”

Stressing on the potential, Shailesh Davey, Co-Founder and Head of Engineering, Zoho added, “Mobile device access and cloud-based remote diagnosis are the two main trends from a software perspective. Mobility of the MRI machine and making it operationally easier in terms of lower power requirements and more efficiency are the two main trends from a hardware perspective. From a business perspective, these trends will lead to lower cost per scan for the patient and more easily accessible MRI scan centres across the country.”

Sharing her views on the same, Dr Geetha Manjunath, Founder, CEO & CTO of NIRAMAI added, “Radiology is clearly the main sector in healthcare where technology will have a huge impact. Radiological images form a key part of digital healthcare and also have a huge historical archive already available. This data can be a great asset to build appropriate AI models. However, AI in radiology cannot replace doctors. AI is very good at detecting the most common types of abnormality. Here AI can make the doctors more efficient as those are the majority of the cases. However, human experts are better at figuring out unusual unseen patterns, which AI systems cannot do effectively.”

Investment opportunities

A low presence of doctors in semi-urban, rural and remote areas has resulted in limited access to healthcare facilities for large numbers of people. Due to the extensive smartphone penetration in India, telemedicine and e-health are already playing an important role as far as accessibility and availability is concerned especially during the pandemic. Similarly, tele-radiology is also an emerging area with several foreign hospitals now active in this space. Investing in start-ups working in this direction is the need of the hour.

Explaining the investment opportunities in the sector, Thatte added, “There are multiple investment opportunities in private as well as government sector (Make in India). Merger / acquisitions, Pvt. Equity Co. pumping funds in to the super-specialty and high-tech boutique hospitals, recently released IPOs by a diagnostic centre, shop n shop working model are the recent-past trending developments. Where budget is a constraint, equipment suppliers or the channel partners collaborate with the doctors in setting-up a radiology and imaging centre for a long lease period with a fixed EMI or sometimes prefer to work on revenue sharing basis with a specific profit and loss accountability wherein the vendor also takes full responsibility of maintaining the equipment. Setting-up and pouring money in teaching medical hospital in rural areas is also the new beginning of heavy investments with assured ROI.”

Sharing his views on the same, Dr Tyagi said, “Radiology in India is at a crossroads right now and the moment is opportune for investing in the technologies of the future wiz. Wearables, artificial intelligence, etc. Early adoption of such technologies currently being tested abroad, their modification appropriate for Indian setting, increasing awareness in general public and familiarization of practicing physicians are some key areas to be focused.”

Dr Dhembare highlighted, “In the post-COVID scenario; new investment opportunities are expected to surface in the radiology and imaging space, including development of cost effective CT scan and MRI technologies, increased demand of more diagnostic centres equipped with advanced imaging modalities in tier II and III cities, building of new AI tools with better algorithms for early detection of acute emergency conditions which would improve standard of care, and enhancements to medical infrastructure through technology-based ptimization. Patient-centric mobile health applications would be in demand where one would be able to access anytime anywhere all the medical data including electronic medical records, pathology reports, radiology images etc.”

Investing in start-ups working in this direction and more focus on the R&D and innovation is the need of the hour.



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