
Why Are Ultrasound Machines So Expensive? - grahar64
http://www.maori.geek.nz/why-are-ultrasound-machines-so-expensive/
======
ska
The cost of components is often not a big part of the cost of producing an
imaging device like this. Building hardware and software in a regulated market
where human safety is involved requires levels of validation, verification,
process control, risk analysis and documentation that can easily dwarf
component cost at the sort of run sizes we are taking about.

This isn't the only thing going on, but it is naive at best to think of the
price of these units as a parts list.

~~~
ghaff
I agree with you but it can still be frustrating and there's a lot of
entrenched interests involved.

My story is that I broke my foot about 10 years ago (in the Grand Canyon no
less). Long story short, when I eventually got the doctor, she told me that
this kind of fracture always took a long time to heal and the literature
suggested that electromagnetic stimulation had some benefit. Of course, the
insurance company wouldn't pay until it was deemed a "problem fracture" in a
few months (as my doctor thought it would be) but I did eventually get my
$1000 stimulator at about 50% off.

It had the most horrible interface one could imagine. If it slipped off the
foot, it apparently simply shut down for that day's stimulation. In any case,
my foot eventually healed.

A few years later, a friend had a similar injury. I gave her my stimulator.
Apparently the allowable stimulations had expired by then. She took it into a
medical supply place and they were horrified by the idea that they might
simply reset the device.

I'm not a big pharma hater but this sort of story is why people get really
mad.

~~~
tn13
Those ridiculous pricing policies are necessary to recover the cost of
regulatory compliance which is seriously huge component of anything medical in
USA.

As a side note, I know a company in India that manufactured a state of art
blood test device. They tried to market it in USA and eventually gave up.
Currently the company has tie up with Singapore hospitals which send blood to
India for testing via flight and reports are mailed electronically
automatically. There is a rig of blood testing machines in Powai-Mumbai which
tests thousands of blood samples each day. This machine clearly can not be
sold in USA (last time I checked was 6 years ago) because the cost of
regulatory compliance is prohibitive.

If the medical device manufacturers indeed made windfall profits I would love
to invest in their stock but they don't seem to be doing as well as the hatred
directed towards them.

~~~
Dr_tldr
My portfolio is about 50% medical supply and machinery manufacturers, and
they're incredibly steady investments which pay strong dividends even and
especially when the stock price is down. Furthermore, they're often able to
make biotech plays and their guaranteed revenue means they're strong
candidates for acquisition:
[http://www.bloomberg.com/quote/HSP:US](http://www.bloomberg.com/quote/HSP:US)

Do you have any sources for your claim that regulatory compliance is hurting
profits beyond a one-off anecdote? Because my experience has been that it's an
industry rife with windfall profits.

Also, what's the name of this Indian company, and what's the brand name for
the device? If it does what you say it does, you would be pretty foolish not
to invest.

~~~
tn13
"More than three-quarters of the cost to bring a medical device from concept
to the U.S. market is spent clearing regulatory hurdles, according to a
Stanford University report."[1]

I am not saying the companies aren't profitable. They aren't profitable the
way people make them out to be.

And if there are indeed windfall profits to be made what is preventing smart-
ass entrepreneurs from jumping in and making those profits ?

Tim Cook says that the Apple Watch won't become a regulated medical device,
but Apple might make another product that is. Cook made the comments earlier
today in an interview with The Telegraph, stating that putting the Apple Watch
through Food and Drug Administration testing would slow its release cycle down
too much and "hold [Apple] back from innovating."

[1] [http://www.massdevice.com/study-fda-related-activities-
cost-...](http://www.massdevice.com/study-fda-related-activities-
cost-24-million-510k/)

~~~
Dr_tldr
"And if there are indeed windfall profits to be made what is preventing smart-
ass entrepreneurs from jumping in and making those profits?"

Incredibly high barriers to entry and very large established players who have
already cornered the market? Following your logic, oil companies must not be
very profitable since there aren't very many entrepreneurs buying their own
offshore drilling platforms.

"They aren't profitable the way people make them out to be."

Who are these people? What is this way?

What concrete assertion are you refuting? How do you explain the P/E ratios of
the biggest medical device companies?

If the cost of regulation is such a drag on profits and innovation, why are
medical supply companies that primarily serve the US market so much more
profitable in the long term than their counterparts in other countries?

Are you alleging that there's a bubble, or that they're cooking their books,
or that they're not one of the most consistently profitable industries?

------
atourgates
All medical technology is insanely expensive.

My wife is an ophthalmologist in private practice, and we've spent far too
much money on diagnostic equipment.

My most frustrating single experience was spending $18,000 on a refurbished
visual field last year (the machine where you see flashes of light in your
peripheral vision and push the button), and having it show up running a custom
version of Windows 3.1 and an actual honest-to-god 3.5" floppy drive.

My current project is trying to figure out how to get digital visual testing
systems (e.g., eye charts on a monitor) setup in her exam rooms. If I were to
buy a system from a medical distributor, I'd be spending something like $2,000
- $4,000 per room.

With an Atom-powered mini-PC, I could get Windows hardware and a monitor setup
in every room for about $300/room. I was hoping I'd be able to find some open-
source visual acuity software, but it doesn't seem to exist. Most software-
only solutions are still over $1,000 per-license per-room. The best-looking
and most reasonably priced Windows software I've found is $400/room. Bringing
my total cost to a (somewhat painful) ~$700/room.

There is one piece of good Visual Acuity software in the Mac App Store[2] that
we'd be able to deploy in all 4 of our exam rooms with a single $99 license.
So with 4x Mac Minis plus monitors, our per-room price would be pretty close
to $700/room going that way too. But it seems like such a waste to spend $500
on a Mac Mini that will do nothing besides display some letters and symbols.

What I'd love to see is industry associations working together to produce open
source software that solves problems like this. Visual testing software isn't
complex. A fairly reasonable investment could get something open source
developed that would lower the cost of healthcare across the country, and
worldwide.

There are about 58,000 Ophthalmologists and Optometrists practicing in the
United States. If we assume they average 2-lanes each, and open source
software could lower the cost of visual acuity testing in each lane from
$2,000 to $300, that would save $98-million.

1\. [http://konanmedical.com/chart2020/](http://konanmedical.com/chart2020/)
2\.
[http://www.kybervision.com/mac/visualacuity/](http://www.kybervision.com/mac/visualacuity/)

~~~
Aeolos
Fancy that, my current project is to create a low-cost, high-quality optical
coherency tomograph for private practitioners. I am planning to open-source
the software and, depending on how things turn out over the next few months,
possibly also the hardware designs.

This device can immediately detect around 80% of the pathologies of the
posterior eye segment. It's high time we made this part of first-line
diagnostic exams.

~~~
HeyLaughingBoy
I don't know if you have an organization around you or not, but be careful. If
your software is actually producing some sort of a quantitative or even
qualititative "you have this visual defect or not" then the FDA may very well
consider you a Medical Device and you'll have to go through submission, etc.

There are a lot of small businesses out there that are unwittingly (and
illegally) producing medical devices and don't even know it (yet!).

~~~
Aeolos
We will be going through the long and arduous FDA and CE approval process.
This is a big part of the cost.

~~~
Toenex
Best of luck with that. As someone who has taken medical imaging software
through both, my preference would be to get CE marking first and allow the
market and the device to become establish before going for a 510K. The FDA
predicate device process together with the glacial speed of the agency means
making modifications to a system is unnecessarily difficult which is something
you will need to do when innovating in a market. I find the CE process to be a
more pragmatic approach.

On some of the darker days with the FDA - and despite their 90 day target we
had over 900 days between submission and final clearance - I found it helped
to remember the famous Churchill quote; "When you are going through hell, keep
going."

~~~
Aeolos
Thanks for the advice. We already have experience with the CE process, it's
painful but doable. The manufacturing company has been cleared for FDA before,
so for now I remain optimistic. (Famous last words...)

------
tacon
A few years ago, my patellar tendon was getting sore from running, and I went
to a sports medicine specialist. At that first visit, he did an ultrasound
scan over the length of my patellar tendons, and it was very discouraging to
see these "black" sections in the mid-core of my tendons. They were actually
tissue that was a bit disrupted, but the way it scattered the sound, it
appeared as "black". Kind of freaked me out that my tendon was "dead" in the
middle. The actual diagnosis was patellar tendinopathy, previously referred to
as patellar tendinitis, or "jumper's knee".

He gave me exercises to build up my tendons, mainly eccentric resistance
exercise, but it was going to take a long time. I wondered how I could monitor
the progress of the healing. The doctor visit and scan was at least
$200/visit, and the healing could take a year. On AliBaba, I checked how much
a low end machine would cost to use at home.

There were all sorts of machines available, and one manufacturer's rep latched
onto me. I still get the occasional email checking if I'm ready to buy. I
think these machines may require some doctor's approval, too, but I never went
that far.

But they sure don't cost anything like the prices in this article. In 2013,
for quantity 1, IIRC, I was quoted $1100/each for this SUN-806F laptop plus
sensor plus software unit:

[http://www.cnsunbright.com/china/english/newshow.asp?Cid=108...](http://www.cnsunbright.com/china/english/newshow.asp?Cid=108&sid=149&PID=135)

Maybe I'm missing something critical in this price difference? As the OP was
explaining, you can almost build one yourself.

~~~
grahar64
OP/author here, I also have patella tendinitis since I dislocated my patella
when I was 17.

This is the reason I started looking at ultrasounds, I figured that I could
buy one for the $160 cost to get a scan from a doctor. I have looked around
for a cheap ultrasound, but $1100 is far cheaper than I was able to find (I
got to about $3k but looked like a dodgy dealer so didn't link to it). But 1k
is still way more expensive than I think it should be.

It should be a sensor you just plug into and iphone for a few hundred. I mean
there is the [http://www.thermal.com/thermal-
cameras/](http://www.thermal.com/thermal-cameras/) thermal camera for only
$250, why not ultrasound? Making a photo sensor must be thousands of times
more complicated than ultrasounds sensors.

I just want to know why I can't buy one cheaper than my massively more complex
iphone :)

~~~
semi-extrinsic
With the math on transducer costs, you've basically answered the question.
However, aliexpress will get you 2MHz transducers 10x cheaper if you buy them
in bulk. Then of course you have to worry about dodgy chinese website
component quality.

I also think you're seriously underestimating the computational cost of
converting the measured signal to a usable image. No way is an RPi fast enough
to produce a live image with decent quality. There are quite a few papers in
the literature about using high-end GPUs to speed up ultrasound imaging and
denoising, for commercial vendors I'm guessing it's custom ASIC territory.

~~~
gherkin0
> I also think you're seriously underestimating the computational cost of
> converting the measured signal to a usable image. No way is an RPi fast
> enough to produce a live image with decent quality. There are quite a few
> papers in the literature about using high-end GPUs to speed up ultrasound
> imaging and denoising, for commercial vendors I'm guessing it's custom ASIC
> territory.

Really? Medical ultrasound has a long history predating high-end GPUs. Maybe
that kind of computing power is required for modern high-resolution/low-lag
devices, but my guess is you could get something usable with a computer as
powerful as a RPi.

[http://www.ob-ultrasound.net/history1.html](http://www.ob-
ultrasound.net/history1.html)

~~~
daemin
I can confirm that you can turn ultrasound data into a 2D image using a simple
mid 2000's era ARM processor and an FPGA. So a RPi can even be overkill for
that purpose.

------
m0llusk
The current heavy hitter in the ultrasound industry is Zonare and the Zonare
Technology page
([http://www.zonare.com/technology/](http://www.zonare.com/technology/))
indicates that they are providing state of the art ultrasound that is much
faster and higher resolution than earlier systems by combining variable sets
of observations. This indicates that the technology that is currently being
purchased and used is substantially more complex than a mere sensor.

Additionally medical markets have very complex purchasing processes and
criteria that require specific marketing strategies to market. Most startups
are used to going for cheap or fast or both, but medical markets want good and
are not nearly as sensitive to price or delivery time. To sell to medical
markets it is necessary to convince medical equipment purchasers that an
option is better and less risky than other possibilities.

Overall this thread is a shameful display of the shallowness and
shortsightedness of startup engineering today. The answers to most of the
questions raised here can be answered by the technology page of the dominant
supplier, but no one bothered to look up any of that. Instead we get
irrelevant broken foot anecdotes. Conversationally that may make sense, but
realistically making the kind of ultrasound machine offering that doctors
might want to use and be able to buy is a very different and more complicated
problem than is suggested by most of this thread.

------
smoyer
I designed an opthalmic ultrasound in the late '80s. The article describes
"b-mode" ultrasound which actually creates an image (in some fraction of a
circle like you see when someone shows you their unborn child). Back then, the
electronics to electrically steer the beam were very hard to create (20MHz was
a fast clock back then) and so the b-mode transducers were often mechanically
steered. there was one transducer that was moved in an arc by the steering
motor and coupled to an acoustically transparent housing by some gel.

Central Pennsylvania (from whence I'm writing tonight) played a key role in
the creation of ultrasound systems - and Johnson and Johnson still
manufacturers their transducers about 15 miles from where I'm sitting. The
technology originally developed for SONAR came to the Pennsylvania State
University where some of the engineers though of cool other ways to use
transducers. Good thing the human body has so much water (or other components
with a similar density and propagation speed.

When you get a b-mode ultrasound, you see the interface between two types of
tissue (or bones) due to reflection. If you look at an image, it takes some
practice to even "see" what the picture is.

So back to the cost issue - the biggest single expense in creating an
ultrasound unit was getting through the FDA approval process. It was grueling
- requiring a lot of testing by outside laboratories and a lot of internal
engineering time for paperwork. Once you start to manufacture them, you're
making (for a small company like ours) hundreds of units and even the large
manufactures aren't making them like the Coca-Cola company spits out cans of
soda. You're amortizing a lot more development costs into each unit.

And then, once you start selling to hospitals and doctors offices, the mark-up
is huge. They in turn pass a large chunk of the cost of the machine to the
insurance companies. If you were charging $500 per scan 20 times a day, you'd
pay for your $8000 machine pretty quickly).

------
asmithmd1
There are Chinese made 3D machines for sale on EBay for less than $1000:

[http://www.ebay.com/itm/Portable-Digital-Ultrasound-
Machine-...](http://www.ebay.com/itm/Portable-Digital-Ultrasound-Machine-
Scanner-System-3-5-Mhz-Convex-Probe-Free-3D-/331342708500)

~~~
c-slice
There is 0 chance that a US hospital or clinician will risk using an off-label
ultrasound machine from china on a single patient. It's almost guaranteed to
not be FDA/CE approved. That's how you get a malpractice suit.

~~~
wongarsu
But the article also talks about the many other potential uses of ultrasound
machines. For hobby use $1000 is still a bit steep, but for classroom use that
might be doable.

------
dzhiurgis
Philips got a device called Lumify, starts at $199 but requires monthly
subscription to use.

~~~
grahar64
Cheers, that is awesome. Here is a video
[https://www.youtube.com/watch?v=HRLHtnza2jM](https://www.youtube.com/watch?v=HRLHtnza2jM)

It seems very limited for purchase, but would be cool to get my hands on one.
I added it to the post :)

------
revelation
If you're patient, you might just find old machines (in some form of working
order) show up on eBay and other marketplaces for old gear.

There is a video series of a teardown/repair of an old baggage x-ray machine
that was acquired this very way:

[https://www.youtube.com/watch?v=KPyE29ABmoA](https://www.youtube.com/watch?v=KPyE29ABmoA)

In fact, looking through the other videos by the same guy, he seems to have a
fair number of xray machines..

~~~
grahar64
How is that legal? :)

~~~
CamperBob2
Our (US) legal system doesn't work that way. If something isn't explicitly
prohibited, it's permitted. This is a feature, not a bug.

While it's not illegal to purchase and use an x-ray machine itself, it would
be illegal to use one on human subjects without the proper training and
licensing. (Unless, of course, you work for the TSA.)

------
esmi
I think the answer is simply NRE is amortized over a small number of units.
This is the case for a lot of test equipment.

------
daemin
So my first job out of University was for a medical device startup, where the
aim was to create a basic but inexpensive ultrasound (compared to huge
"portable" ultrasound machines). They are still in business (I have friends
still working there, 10+ years now) but for some reason they are not mentioned
in any articles such as these, even though the product fits a lot of the
requirements listed.

~~~
boca
Startup name please?

~~~
daemin
A little company in Adelaide, Australia called Signostics (pronounced Sig -
nostics).

[http://www.signostics.com.au/](http://www.signostics.com.au/)

------
c-slice
Here are a few more reasons:

1) High touch sales process, slow sales cycles - ultrasounds take a long time
to sell to hospitals/clinics so the sales process is very high touch and
requires a significant number of demos and in person time. Those sales reps
are usually paid on commission. Cheap products don't make sense to sell this
way.

2) Lack of competition and high development cost - Ultrasound machines are a
Class II medical device and so are regulated by the FDA. FDA requires
compliance with most relevant ISO standards, and there would probably be a
dozen relevant standards for an ultrasound machine.

3) Liability - complex medical devices that are used for critical diagnoses
create big liability problems for the hospitals/clinicians. They have no
incentive to choose the low-cost model sold by a startup. No one ever got sued
for choosing GE/Philips/etc.

4) Lack of price transparency - its often hard to find prices for big ticket
medical devices, so the natural pressure to reduce costs through competition
isn't as effective, especially with a high touch/high cost sales process.

~~~
Gibbon1
When I hear excuses about how some diagnostic test is expensive because the
machines are expensive I think of airplanes and rental cars.

So you say your ten year old ultrasound costs $50k? I can rent a $50k
automobile for $150 a day, not for just ten minutes. And rent a space on a 120
million dollar airplane for a few hundred. And seriously, mom was an
accountant. The capital cost of a $50,000 ultrasound machine is about $20/day.

Meanwhile I have about $50,000 worth of test equipment sitting in my office.
I'd never think of charging a customer a $2500 spectrum analyzer fee. Or a
$400 oscilloscope diagnostic fee.

Please.

------
rdtsc
Ultrasound machines of some sort is also pretty popular startup idea. I've
heard at least of 3 people through personal connection who were building some
sort of "ultrasound" device based startups. All have had proof of concepts and
all have failed. I am guessing failing to deal with regulation, and other such
red tape.

------
z3t4
When I was in the training business I was thinking of buying an ultrasound
device. Yes, they are expensive, but the hardest part is you need a lot of
training, even if you know your anatomy by heart, it's hard to make something
out of the image.

I think it can be greatly improved by better software, so it get's closer to
an MRI.

------
n00b101
To answer the question, it is because OP (Graham) hasn't created a startup to
solve this problem.

When my wife was pregnant we went to a lot of ultrasounds, and I observed
those big Phillips machines very closely, they definitely have room to improve
on multiple dimensions.

~~~
spydum
Like a "post image to Facebook" or tweet this image button on the console? /s

------
mathattack
They could just as well be asking, "Why is Salesforce so expensive when the
marginal cost of each additional user is negligible?"

The answer is that the market price reflects a lot of other costs than just
parts for adding an incremental user.

------
madengr
10 years ago when my wife was pregnant, a dianostic ultrasound cost $800, took
15 minutes, and the machine looked ancient. A 3D "fun scan" was $150, took 1
hour, and the machine was state of the art. Go figure.

~~~
Gibbon1
Thing I harp on is that the medical industry is used to just charging whatever
they can get away with. Since they have a generally naive and captive customer
base, there is generally nothing to keep things real. My small experience with
business is that when you have that situation you're set up to totally lose
control of your costs. Because a lot of excess expenses are hidden in high
margin products and services. Example, you make something for $5600 and sell
it for $15,340. Could be that with a small amount of work you could produce
the thing for $4200 ea. But because the margin is 'good' no one feels the
need.

~~~
HeyLaughingBoy
Actually my experience with the medical industry is that products get "value
engineered" to oblivion. They are acutely aware of their margins and are
constantly trying to improve them by reducing costs where it doesn't affect
performance.

~~~
Gibbon1
In some parts of the device industry there is actual competition though.

------
spyder
[http://www.dailymail.co.uk/health/article-2203114/Pregnant-w...](http://www.dailymail.co.uk/health/article-2203114/Pregnant-
wife-inspires-engineer-build-affordable-hand-held-baby-scanner-save-thousands-
lives.html)

[https://vimeo.com/49436607](https://vimeo.com/49436607)

Looks like they use one or just a few transducer and move it manually to
reduce the cost.

~~~
kelu124
Indeed! That was a solution used 30 years back =)

------
ck2
They wanted $600 to ultrasound me when I had gallstones, it's a racket.

Had to skip on that and just ate more fiber instead which thankfully solved
that (pain was unbelievable).

~~~
datenwolf
More fiber will not help you with gallstones at all (had to deal with them,
too); it's fats you've to be carefull about. The problem is not fat in itself,
but which other foods you combine it with.

> They wanted $600 to ultrasound

Well, they were asking that for the procedure, not for the device. The problem
you had is, that you're probably living in a country with a laughable
healthcare system. Guess what I did pay for my ultrasounds? Nothing, because
it's covered by our mandatory insurance system. In fact most general
practitioners have ultrasound machines (quite modern ones, too, I'd like to
add).

~~~
ck2
would beg to disagree with you about fiber (you are right about the
healthcare, if anything the price is only higher now that more people have
insurance rather than price reform)

after a few bad attacks over a couple years, it finally dawned on me to
radically increase my fiber intake after reading up on it online

no attacks for years now

initially I had reduced my fat intake but now far less careful without any
downsides

cannot imagine anything worse than gallstone attacks, I literally thought I
was dying the first time it ever happened

~~~
datenwolf
> cannot imagine anything worse than gallstone attacks, I literally thought I
> was dying the first time it ever happened

I know that just too well. In case one ever happens to hit you again, I found
out that a hot bath will give you instant relief. Don't ask me how it works
exactly, I just found out, that it works.

------
raverbashing
" computer that can run a MHz frequency transducer is easy and cheap these
days, e.g. a raspberry pi’s GPIO pins can run that frequency."

Yeah, but actually you need an ADC that runs at MHz frequencies and a frontend
amplifier to capture the signal and put it into the ADC

Definitely this falls into the "not expensive" category, but not in the
"trivially cheap" one

~~~
kelu124
Agreed, for a single element one there's a project on hackaday :
[https://hackaday.io/project/9281-murgen](https://hackaday.io/project/9281-murgen)
=)

160$ cost for a single electronic board, not cheap, not so expensive..

------
ChicagoBoy11
This is a phenomenal article outlining how the regulatory environment
essentially causes these devices to be far more expensive than they really
ought to be:

[http://faculty.chicagobooth.edu/john.cochrane/research/paper...](http://faculty.chicagobooth.edu/john.cochrane/research/papers/after_aca.pdf)

------
go13
Can anybody who is knowledgeable in this area tell me if it is possible to use
later interference to build ultrasound transducer? Similar to how gravity wave
detector works but for 2 dimensions?

------
datenwolf
Actually "Ultrasounds" are among the cheapest medical devices around.
Practically "everybody" makes them and the market is oversaturated.

The processing software is actually the least problematic thing; it's all well
documented and somebody with the right background (electronics, digital signal
processing and computer graphics) could hack it in a single weekend (that's
not an exaggeration: When I got invited to the group where I'm currently doing
my PhD they were giving me a few datasets of raw, unprocessed Swept-Source OCT
fringe data and said "have fun". A day later, using liberal application of
NumPy I got pictures; another day and the quality was pretty good.

"Ultrasounds" cost more than consumer goods, because, at the moment, they are
not consumer goods. Compare this to the cost of "personal computers" in the
1980-ies. Just about as expensive, and "Ultrasounds" are kind of the medical
imaging "PC" counterpart for general practitioners.

So can "Ultrasounds" be made consumer goods? Difficult, because some parts of
them must be built at very high quality standards, not to put the patient at
risk. Also some of the electronics involved is challenging, even by todays
standards. For example driving the transducers requires driving amplifiers
capable of outputting >1kV against a highly complex and poorly matched
impedance at bandwidths above 1MHz. That's a really tough problem, that,
luckily, has been solved but still requires fairly complex electronics; you
can buy appropriate driver amplifier ICs, but those are not cheap, often >10$
per Unit and you need several of them. But that's only half the story: You
also need to receive the reflected signal. Here's the problem that the
transducers tend to ring after emitting the pulse, causing signal artifacts.
And the waves coming back will produce only a few µV of signal. So you've got
a 180dB dynamic range between sending and receiving and TX and RX share parts
of the signal path; either your RX amplifier can cope with the 1kV sending
signal and quickly enough recovers, or you have to add some fairly quick, high
insulation signal path switches to quickly switch between TX and RX.

And finally you need a whole array of medium speed ADCs (each with a sampling
rate of about 10MHz to allow for some oversampling) one for each channel; and
of course the interface to the computer. A single 10MHz ADC is cheap. But as
soon as we enter the multiple channel interfaces domain things get pricey
quick. Just look at audio which operates at most at nimble 96kHz, yet "pro-
sumer" (enthusiast consumer) audio interfaces with 16 or more channels go over
1000$; And we need 100 times the sampling rate for ultrasound. So actually the
about 3000$ you pay for the ADCs is pretty cheap, if you compare the MHz/$.

So you've solved all these essential problems. Now you have to make sure, that
a mechanical failure doesn't expose the 1kV driving signal to the transducer
to the patient. Here's the challenge: The transducers are separated by the
thinnest possible layer of isolation material from the patient's skin, there's
a pulsed >1kV amplitude AC signal right behind it, and between the probe and
the patient you have conductor gel, which is essentially water jelly, that
gives a nice acoustic impedance match, but also does a very good electrical
match; we're talking body resistivity model in the two-digit ohms right now.
Or in other words: A single manufacturing failure in your scanhead probe and
you're going to electrocute the patient. Oh, you're thinking about just
floating the whole transducer driver electronics. Smartass, that won't work,
because you're operating with MHz AC here, so we're talking RF coupling,
driving transducers with significant pulse power; you'll giving your "victim"
RF burns, which are nasty.

Come to think about it: 8000$ for a ultrasound imaging unit sounds pretty
cheap.

------
awqrre
Buy it from unregulated Chinese providers for personal use?

------
tlarkworthy
Compared to an MRI machine it's very cheap

~~~
datenwolf
The funny thing about this is, that technologically an MRI is much simpler
compared to an ultrasonic imager:

\- Field coil \- Gradient coils + coil driver \- RF transceiver (essentially n
SDR)

The single most expensive part is the cryostat for the field coil. If there
were high temperature superconductors that would retain their properties
within strong magnetic fields you could build and operate MRI scanners much
cheaper.

A few years ago I did build a very crude and simplistic MRI scanner in my
shack; it had a piss poor resolution of about 10mm³ took "ages" to scan a
single plane and would dissipate huge amounts of heat in the (normal
conducting) field coil; the gradient coils were driven by a regular HiFi audio
amplifier. But it is definitely possible to build such a thing DIY and have it
produce images (of poor quality).

~~~
tlarkworthy
Wow that's really amazing. The super conductors are annoying in that they self
distruct. I wonder if there is a cheap way to make one and gracefully shut it
down when finished with it.

I met one of the original engineers for ultrasound. The original design was 3d
through mechanical scanning of the body

------
vacri
"Why is custom software so expensive to produce? Open-source components are
_free_ , so the final product should be, too!"

