Medical imaging seeks to reveal the internal structures hidden by the skin and bones in order to diagnose and treat diseases. It comprises different types of modalities depending on the physical nature of the waves used and the method of image capture, such as X-ray, MRI, CT, ultrasound, etc. Medical imaging can be used for both diagnostic and therapeutic purposes and is an essential component of clinical practice and the healthcare system.
This article aims to give an overview of the global medical imaging market, present and future; analyzing the factors that explain its growth, as well as the main trends and key players that could mark the future of medical imaging. Other topics such as regulatory strategies, cybersecurity and protection will also be discussed. Finally, a SWOT analysis will be done to conclude with the most determining factors.
To get an overview of the medical imaging market environment and its technologies, a PESTLE analysis is performed (Taulí 1)
Taulí 1. Key factors in the different areas of PESTLE. Source: Markets and Markets, 2021.
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The most common medical imaging techniques are shown in the following table:
Taulí 2. Most used imaging techniques with their description, types of technologies and applications. Sources: 1) Michael S. Tehrani, 2020, 2) Fatma El-Zahraa et al., 2016, 3) Markets and Markets, 2021
| Technique1 | Description2 | Technology3 | Application3 |
|---|---|---|---|
X-rays
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X-rays, or radiography, use ionizing radiation to produce images of the body's internal structures | -Digital Imaging Systems
-Analog Imaging Systems |
– General radiology
– Dental - Fluoroscopy – Mammography |
| CT
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Computed tomography (CT) uses X-rays to produce a series of images based on cross-sections using the computer | - High-slice CT
-Mid-slice CT - Low-slice CT -Cone Beam CT |
– Cardiology
– Oncology – Neurology – Others |
| MRI
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Magnetic resonance imaging (MRI) produces “slices” that represent the human body through the application of magnetic signals. It lasts longer than a CT and is more detailed | – High- and – Very-high-field
-Low-to-mid-field – Ultra-high-field |
– Cardiology
– Vascular – Musculoskeletal – Neurology - Mom |
| Nuclear Image
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A non-invasive technique where, through the ingestion of radioisotopes, images are produced that reflect biological processes that take place at the cellular level | -Standalone SPECT
- Hybrid SPECT -Hybrid PET |
– Cardiology
– Oncology – Neurology – Others |
| Ultrasound
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Technique based on sound waves and capable of producing quantitative and qualitative diagnostic information | – 2D Ultrasound
– 3D & 4D Ultrasound – Doppler Ultrasound |
– Radiology
– Cardiology – Gynecology – Urology – Vascular – Others |
From the moment a patient enters a hospital for a radiology exam to the result, information travels through a work flow which integrates appointment, programming, image acquisition, storage and display (Figure 1).
Figure 1. Medical imaging workflow with the computer system used in each step. Adapted from Andrei Leontiev IHE (Integrating the Healthcare Enterprise) and Telerad Tech.
Un Integrated information flow allows for better efficiency in radiology patient care and ensures the availability and consistency of patient data. Implementing an integrated workflow allows the hospital to (i) reduce errors and improve patient care, (ii) improve performance, and (iii) reduce cost/time4.
The global medical imaging market in terms of revenue was valued at USD 26,52 Billion in 2020 and is expected to reach USD 35,78 Billion by 2027, growing at a 3,99% CAGR the 2021 to 20274 (Figure 2).
Figure 2. Global Medical Imaging Market Size Overview: Growth and Key Segments. Sources: Brand Essence Research and Grand View Research.
The global medical imaging market is expected to grow at a substantial growth rate due to various factors5,6:
- Increase in the prevalence of chronic diseases
- Growing geriatric population
- Technological advances in medical imaging
- Increased demand for early diagnosis and minimally invasive treatments
- Growing awareness of the benefits of medical imaging
- Increased adoption of advanced technologies in medical imaging
- Increase in healthcare spending
- Increase in investment and repayment initiatives undertaken by the government
- Expansion of facilities in emerging countries
The medical imaging market can be segmented based on imaging technique, application, region, and end user.
IMAGE TECHNIQUE
- El ultrasound segment dominated the world market by 2021 (28% of global revenue) and is expected to maintain its leadership over the coming years (Figure 3). The growth of the segment can be attributed to (i) increasing number of ultrasound applications, (ii) new ultrasound devices in biomedical and cardiovascular imaging, (iii) development of portable ultrasound devices for care ambulatory and emergency and (iv) integration of AI in ultrasound systems to automate the process of image quantification and selection7.
- It is expected that the CT segment is the fastest growing due to (i) high demand for CT Point of Care (POC) devices, (ii) development of high precision CT scanner through AI and ML integration and advanced visualization. systems Additionally, CT scanners experienced tremendous growth due to COVID-197.
Figure 3. UK Medical Imaging Market Size by Technique (Product), Current and Forecast 2020-2030 ($Million). Similar patterns apply globally. Source: Grand View Research.
REGION
- It is expected that North America dominates the global medical imaging market due to (i) increased prevalence of chronic diseases, (ii) increased product launches and other launch frequency, (iii) increased investment and strategic collaboration, (iv) the increase in the aging population in this region, and (v) the presence of many players in the sector5.
- Asia-Pacific is the fastest growing market (figure 4) due to technological advances, together with reserves and government support funds, especially in emerging countries, such as India and China5.
- El hospital segment dominated the world market by 2021 (Figure 5) and accounted for 47% of total revenue, due to (i) growing demand for advanced imaging modalities, (ii) the integration of imaging technologies in surgery, and (iii) l entry of multinational health service providers.
- It is estimated that the diagnostic imaging centers segment has the highest growth rate due to (i) increased adoption of advanced technology, (ii) improved infrastructure and (iii) high funding for the growth of these centres.
Figure 5. Global medical imaging market share by end user, 2021 (%). Source: Grand View Research
ARTIFICIAL INTELLIGENCE (AI):
AI is becoming an important component of many applications within the healthcare field, i radiology is the medical specialty with the most AI tools (about 75% of AI medical devices cleared by the FDA to date are in radiology, source: FDA).
Integrating AI components within the medical imaging workflow can increase efficiency, reduce errors i address the shortage of radiologists in some countries or prevent them from having burnout thanks to time optimization.
There are several areas throughout the imaging workflow where AI tools are applied, some examples include intelligent appointment scheduling, prioritization and triage, workflow orchestration, language processing natural etc. (figure 6).
Figure 6. AI use cases in medical imaging workflow. Source: Frost & Sullivan, 2020.
VIRTUAL AND AUGMENTED REALITY (VR/AR) AND 3D MEDICAL IMAGING: VR/AR and 3D technologies are becoming increasingly popular in the field of medical imaging due to their ability to provide a more immersive and interactive experience. VR/AR and 3D technologies allow medical professionals to visualize medical scans in a 3D environment, which allows better interpretation and diagnosis of medical conditions. These technologies can create detailed models of a patient's anatomy, helping medical professionals better understand complex medical conditions and plan ahead of a medical procedure.
NUCLEAR IMAGE:
Nuclear imaging is increasingly popular in medical imaging because of its ability to provide a dynamic view of the body and its organs. By using small amounts of radioactive molecules (tracer), nuclear imaging can detect small changes in body chemistry that traditional imaging methods cannot, allowing the early detection of diseases and more accurate diagnoses.
WEARABLES:
The technology w became popular in the field of sports. However, some applications using devices are being studied w for monitor and control internal organs (such as the lungs, heart and brain) in aging populations. Portable imaging devices could set a standard for the future of medical scans, but today they are still in the research phase.
The medical imaging market is quite fragmented due to the presence of several players in the market7. The most prominent companies that have been identified are shown below (Figure 7).
Figure 7. Key players in the medical imaging market, grouped in the areas they dominate. Source: Grand View Research, 2021; Definitive Healthcare, 2022; Future Market Insights, 2022.
Corporations and startups have launched products for radiology with disruptive technologies in recent years, especially in AI (Taulí 3 and Figure 8). For these products, the market is even more fragmented due to the high number of companies. These companies will play a crucial role in the future of radiology, considering that AI is one of the most important trends in the market.
Taulí 3. Companies with commercially available AI products in multiple areas of radiology and area of activity. Adapted from: van Leeuwen et al., 2021
Figure 8. Companies with commercially available AI products in radiology and area of activity. Adapted from: van Leeuwen et al., 2021
Taulí 4. Most relevant institutions in radiology and medical imaging. Source: Scimago Institutions Rankings
| Institution | Activity | Link |
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His research spans a variety of imaging modalities from CT to PET, MRI and optics, with expertise in various techniques from reconstruction and kinetic modeling to radiotracer development | link |
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They research in different areas of Radiology such as 3D innovation, AR and machine intelligence, magnetic resonance, molecular imaging, etc. | link |
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Research divisions include cancer imaging, magnetic resonance imaging and radiological physics | link |
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They focus on innovative optical methods that enable new visualization of living biological tissue | link |
Taulí 5. Main radiology, nuclear medicine and medical imaging journals according to SCImago Journal Rank (SJR) indicator. Source: Scimago Institutions Rankings
| Magazine | SJR | Link |
| JACC: Cardiovascular Imaging | 5,91 | link |
| Radiology: Artificial Intelligence | 4,73 | link |
| Radiology | 4,59 | link |
| Ultrasound in Obstetrics and Gynecology | 4,44 | link |
| Medical Image Analysis | 4,17 | link |
Medical imaging devices are considered medical devices by the main regulatory agencies (EMA in the EU and FDA in the US), therefore they are regulated by their respective laws and regulations (Taulí 6).
Taulí 6. Regulations for medical devices in the EU and the US.
| EMA (US) | Medical devices are regulated by the Medical Devices Regulation (EU) 2017/745. The latest version of this regulation also includes medical device software (MDSW). Manufacturers can use the CE (Conformité Européenne) marking on a medical device once it has passed a conformity assessment11. |
| FDA (US) | Devices used in medical imaging are considered medical devices under the federal Food, Drug, and Cosmetic Act (FD&C Act). Most existing medical imaging technologies are considered Class I and Class II medical devices by the FDA, being eligible for authorization depending on the pathway 510 (k). The FDA recently published guidance on “Clinical Decision Support Software,” which aims to clarify the scope of FDA oversight of clinical decision support software12. |
Medical imaging devices are increasingly connected to the Internet, hospital networks, and other medical devices. These same characteristics also increase the potential cyber security risks. Medical devices, like other computer systems, may be vulnerable to security breaches, which may affect the safety and effectiveness of the device; therefore, manufacturers, hospitals and facilities must work together to manage cybersecurity risks13.
Medical imaging products can consist of both software and hardware (device, sensors, monitors, etc.). Protecting abstract ideas, software and digital technologies can be complicated in some jurisdictions, which is why it is important to consider which elements we are most interested in protecting and choose the most appropriate strategy (Taulí 7).
Taulí 7. Intellectual protection strategies for medical imaging devices and software with their description. Source: Mark J. Diliberti et al., 2009.
| Strategy | Description |
| Copyright | Copyright protection can be granted to “original works of authorship fixed in any tangible medium of expression”. This strategy can be used to protect the software (either of the medical imaging device or an embedded tool), the design of the device's outer casing, and the look and feel of the user interface. |
| Trademark | It can be used to protect the name, symbol or slogan of the medical imaging device as well as yours look and feel or aesthetic design. It is an interesting strategy to protect brands that can give good connotations to the product and make it more attractive to the customer. |
| Utility patents | A utility patent can be requested on any “process, machine, manufacture or composition of new and useful matter”. It can be used to protect many aspects of the medical imaging device and lasts for 20 years from the date of filing, but obtaining the patent can be a long and expensive process; which could be a disadvantage especially for digital tools. |
| Design patents | It allows you to protect the form or design of a product, but not its function. The design aspects of some digital medical imaging tools can be a key factor, making this type of strategy particularly interesting. It lasts 14 years from the date of issue. |
| Trade Secret | Trade Secret protects information that may have economic value by keeping it secret. Trade secrets can include software code base, business plans, customer lists, marketing strategies, and process-related inventions. It's a strategy widely used with medical imaging device software and related tools. |
Taulí 8. Interesting Spanish companies that innovate in medical imaging.
| Company | Description | Link |
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Solution designed for the storage, visualization, management and exchange of medical data | link |
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World leader in medical image analysis | link |
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Support for assessing stroke detections from a simple neurological exam and non-contrast CT | link |
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AI-based algorithms to support the diagnosis of abdominal lesions (focusing on the pancreas) and the prediction of their evolution | link |
Taulí 9. SWOT analysis of the medical imaging market. Source: Markets and Markets, 2021.
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FORTRESS
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WEAKNESSES
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OPPORTUNITIES
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THREATS
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- Michael S. Tehrani, 2020 https://www.marketsandmarkets.com/Market-Reports/diagnostic-imaging-market-411.html
- Fatma El-Zahraa et al., 2016 https://www.sciencedirect.com/science/article/pii/S111086651500047X?via%3Dihub
- Markets and Markets, 2021 https://sdbif.org/whats-the-difference-between-all-the-different-head-scans/
- RamSoft, 2022 https://wiki.ihe.net/index.php/Scheduled_Workflow
- Brand Essence Research, 2022 https://brandessenceresearch.com/healthcare/medical-imaging-market
- Grand View Research, 2021 https://www.grandviewresearch.com/industry-analysis/medical-imaging-systems-market
- Mordor Intelligence, 2022 https://www.mordorintelligence.com/industry-reports/medical-imaging-market
- Frost & Sullivan White Paper – A Practical Guide for the Implementation of Artificial Intelligence in Medical Imaging
- Definitive Healthcare, 2022 https://www.definitivehc.com/resources/healthcare-insights/top-PACS-number-installs
- Future Market Insights, 2022 https://www.futuremarketinsights.com/reports/radiology-information-system-ris-market#:~:text=The%20top%20players%20in%20the,Inc.%2C%20MedInformatix%2C%20Inc
- EMA, 2022 https://www.ema.europa.eu/en/human-regulatory/overview/medical-devices
- John J. Smith, 2006 https://www.mddionline.com/radiological/medical-imaging-basics-fda-regulation
- FDA, 2022 https://www.fda.gov/medical-devices/digital-health-center-excellence/cybersecurity
- Mark J. Diliberti et al., 2009 https://www.mddionline.com/news/which-type-ip-protection-right-your-medical-device
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