Acceptance of ultrasound in Asia-Pacific requires education

But demand may eventually dominate the region

Ultrasound sales have great potential in the dynamic Asia-Pacificregion, given their low cost, mobility and diagnostic versatility.However, ultrasound use may require some time to establish a footholdamong regional physicians.

Compared to x-ray and CT, the Asian radiology market is relativelyunacquainted with ultrasound technology, said Hiroshi Hosoya,assistant general manager for the international division of HitachiMedical in Tokyo.

"In a sense, it is rather more new than CT or MR,"he said.

CT continues to be the fastest growing imaging modality inAsia-Pacific, Hosoya told SCAN. The x-ray based technology hasbeen considered by many regional physicians as a natural extensionof standard x-ray, requiring similar diagnostic skills.

Ultrasound is quickly losing its handicap, however. The Asianmarket for ultrasound should follow past trends in the U.S., Europeand Japan with a five to 10-year lag, he said.

"Looking five or 10 years ahead, I think ultrasound willbe the number-one modality," Hosoya said.

While Asia-Pacific's economy outside of Japan continues togrow at a healthy pace relative to other world regions, the impacton imaging modality sales has been varied, he said.X-ray salesare flat in the region, as they have been for the past decade.MRI is second to CT in terms of sales growth.

"Everybody is looking at Asia," Hosoya said.

Many of Hitachi's multimodality imaging competitors, includingGE and Siemens, are considering both the region and ultrasoundas growth opportunities. The trend to premium systems and increasedultrasound use that has taken place in the U.S., Europe and Japanwill also occur in developing Asia-Pacific, he said. However,mid- and low-end ultrasound systems will predominate in the regionuntil demand for premium scanners picks up in three to five years.

This does not mean, however, that Asian physicians prefer scannersthat are less than state-of-the-art by international standards.

"If someone buys an ultrasound system in Asia, they wouldlike to buy a high (technology) unit," Hosoya said.

Regional sales of MRI systems have been picking up for Hitachi,although the Japanese vendor has done better with its low-costCT offerings. Hitachi has sold MRI units in Taiwan, Thailand,India and Indonesia, he said. It has even lifted an MRI systeminto Nepal using an army helicopter.

Asia-Pacific outside Japan was actually a trial market forHitachi's MRI line before the vendor brought it to the hotly competitiveU.S. market several years ago. Hitachi has been successful inthe U.S. exploiting demand for relatively inexpensive, easilysited mid-field systems using permanent magnets. This same technologyprovides cost and siting advantages for MRI in developing markets.

Whenever Asia-Pacific market prospects for medical imagingare discussed, the conversation centers around China. Hitachihas been working for years in this vast yet underscanned market.

Decentralization of scanner purchasing and China's rapidlychanging legal and regulatory environment have created a complexbut increasingly open market, Hosoya said.

"Until about 10 years ago, we would do everything throughone or two (government) organizations. Now it is more complicatedand difficult for us, but, on the other hand, we have more routesto obtain access," Hosoya said. "The Chinese (medicalimaging) market will be one of the largest in the world in 10years or sooner."

Despite Communist control in China, change comes easier forthe Chinese than it does in other more traditional societies suchas India, he said. Capitalism never completely vanished from Chinesesociety. The Chinese still remember, for instance, when Shanghaiserved as an international business center 60 years ago.