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.
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.
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.
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.
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."
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?
I believe the way forward is with open, LGPL-style, reference designs, almost like the Red Hat enterprise model. individual companies must still be accountable and liable for their devices, but their real value-add is in the verifications and validations.
The auto industry doesn't share software, but the liability model is similar in that: how to build any car is mostly known, there are few important secrets. You choose your car based on features and quality and the companies provide those validated features and quality to customer expectations.
Reference designs in medical devices would especially help with the security crises we're undergoing.
So you could buy, say, an insulin pump based on a reference design from a dozen different manufacturers, but your feature set and quality of materials would be up to you and your insurance company. This is the best compromise I can find which allows competition to improve quality and spur development (competition is weak in med. devices) yet allows thousands/millions of eyeballs to improve software - and therefore life - quality.
The holy grail is a medical-grade embedded Linux. If any hardcore entrepreneurs want to talk with me about that, I have a lot to share on it.
> That device practically screams, "hack me".
As in, "That device practically screams, 'please find a way to tweak me to overcome my restrictive and unreasonable limits (embedded in what is otherwise a functional device)'"
Or in other words, "hack me".
The amount of people that were employed to simply test, do documentation, and verify safety alone was staggering, let alone all the smart people it took to develop custom ASICs, FPGAs, mechanical housings, image processing etc. There are physicists who do research, there are sonographers who help achieve the best possible images for clinical scenarios.
The amount of effort it takes to make a high quality, safe, ultrasound is immense. When you add in the fact that you also need to follow a myriad of FDA regulations, even small code changes often require a huge amount of overhead in documentation and review before they get checked in, and then there will be whole teams of people to manage source control.
Ultrasound companies do an immense amount of R&D, but also put out a safe, well-regulated product, and the prices reflect that. I'm surprised the the author in the article found even a low quality ultrasound as cheap as he did.
Not saying that's how FDA approved devices should be developed, but don't be surprised if "prosumer" grade equipment starts penetrating the medical field especially if anyone gets the cost incentives right.
I fear the market niche between "scam" and "not a scam" might be very narrow.
For example, I am from Mexico, and cysticercosis (a brain parasite infection) is not uncommon in rural areas in Mexico. MRI scanners, which can be used to detect it, on the other hand, are quite uncommon outside of major cities. This might or might not be a good example, since I don't know the cost/safety trade-offs for MRI or all the alternative solutions, but if one could get, say, $20,000 USD MRI scanners that are close to in practice to $1 million ones, it might be worth a small safety delta. Public health in Mexico at the national level also tends to fall under "generally trustworthy enough, but critically under-resourced".
Edit: Again, not sure how realistic this particular scenario is, but I think in general getting cheaper equipment for national health services might be worth it in cases where having a lower-standard device can save an order of magnitude more lives than it harms.
However, in many countries, enforcement is lax, so you get lots of devices that don't come close to meeting whatever regulation is in place.
Actually you have to validate the iteration of the product. So if your software changed significantly enough from version 1.0 to 2.0, enough that the results of processing data may have changed, now you have the pleasure of going back to validate the entire product to ensure it still works as expected instead of just doing a software verification.
Sucks, but it's the price of safety.
One of the stories I love to tell from my medical device days was spending about 6 weeks getting the validation procedure document for a software build machine approved and then spending all of 5 minutes actually building the product (which had to be separately validated), never to use the build machine again. Now, that's crossing the line into stupidity!
What you are talking about is access to medical care, which is an entirely different topic
There are cases where individual elements of a system must be validated separately, but even then, the system as a whole still has to be validated.
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 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.
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.
There are a lot of small businesses out there that are unwittingly (and illegally) producing medical devices and don't even know it (yet!).
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."
I think we paid ~$13K for our Atlas OCT (Placido Disk), and ~$43K for our Cirrus OCT (Spectral domain). Both refurbished, a few years old.
This is spectral-domain OCT with tracking, so quality falls somewhere between Cirrus and Spectralis. However, I'm working on a few sweet mathematical tricks that actually surpass anything available on the market right now - hardware and software has advanced hugely over the past few years.
We already have a hardware manufacturer and are currently fighting to secure the necessary funding. This technology has to make it out there.
Personally, I'm working at exactly the other end: Ultra-High-Speed OCT. 1.5MHz and higher A-Scan rate (our group still holds the record of 20MHz equivalent A-Scan rate for a 60°×60° @ 1900x1900 scans posterior segment OCT system).
Right now I'm working with 70K ascans/s (we've also built a faster swept-source prototype, but the cost-benefit analysis doesn't work out just yet). We have higher-than-average losses due to the slit lamp, so sensitivity is slightly lower than fully-custom systems. We make up for that in post-processing.
I find amazing how far things have progressed in just 10 years. In a decade, we went from struggling to acquire and process x10^2 ascans/s, to real-time processing of x10^5-10^6 ascans/s.
> to real-time processing of x10^5-10^6 ascans/s.
That would have been me :) (the real-time processing on the GPU part), second author on the paper:
If you want to, you can buy our systems from our university spin-off company: http://optores.com/index.php/products/18-mhz-oct-system
I just find it mindblowing how efficient GPUs are at processing this kind of data. I've written implementations for a 6-core DSP (40K ascans/s), modern 4-core CPUs (~70K), 12-core server CPUs (~180K), my laptop's AMD GPU (>120K), a desktop Nvidia 980 GPU (more ascans/s than I care to benchmark.) From a price/performance/simplicity point of view, the GPU outperforms anything else out there right now.
Right now I'm putting this extra computing power to improving quality in other ways than the regular OCT signal processing pipeline. 1M+ ascans/s OCT is great because it opens up new use-cases - I'd love to work on those one day in the future - but there's still a surprising amount of untapped potential in 100K OCT (in the sense that 100K + better processing can actually give better image quality than 1M + typical processing.)
But even at $500 you're buying a computer that has an excellent track record for reliability and industry-leading warranty support. It might seem like overkill but compare that to the time investment you'll sink into a hacked and unsupported solution.
(Believe me, I've played with enough of those cheap Atom PCs to know that I'd never, ever rely on them.)
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:
Maybe I'm missing something critical in this price difference? As the OP was explaining, you can almost build one yourself.
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/ 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 :)
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.
3D scans are another matter, but this is a thread about low cost scanners, so that's out of the picture.
Cheaper thermal imaging sensors like that usually use a very, very low resolution sensor for picking up thermal data, then use interpolation to map the low-resolution data onto a high-resolution image provided by a higher-res conventional camera sensor. Obviously, this approach won't work with ultrasound tech, as there wouldn't be a secondary high-resolution data source.
The key is that the 1600 sells deliver more than one input over time, from a nonstatic signal, which is like shooting photos from different perspectives. I believe cell correlation or whatchamacallit is done in all kinds of variation for CCD data, too.
What makes you think that?
Photo sensors have no moving parts, photons are the carriers of the electromagnetic force, so they readily interface with electronics given the right interface material; any semiconductor material with a matching bandgap will do, photons interacting with a bandgap produces free charge carriers; this is exactly what you're after. The rest is chipscale manufacturing, i.e. lots of sensor cells in a repetetive pattern. You can easily mass produce that in large quantities using photolithography methods, yet even if your process were to bad, that you'd get a low yield it would still be profitable.
Ultrasound on the other hand is acoustics, i.e. mechanical waves. So you're dealing with moving parts, mechanics. Transducers are discrete parts, they can't (yet) be manufactured at chip scale. They're ceramics, and there are lot of parameters that go into manufacturing ceramics which limit the amount that can be produced in a single batch. And then you've to deal with electronics that's not over waaay beyond your typical hobbist level; it's in fact so complex that it goes over the head of most professional electrical engineers and there are companies who are specialised in ultrasonics transducer electronics consulting, doing the difficult design work for the large brand names.
Second, your estimate on the price of PZT elements is not necessarily realistic as the transducer is rather large(22 mm in diameter). A 10X10 array would be impractically large. One can buy PCB mount piezo elements for motors for cents per element in bulk. It might even be possible to modify one of those expensive components into an array as was done in this homemade STM. Although in both cases there are bound to be issues with impedance matching and potentially changes in resonant frequency.
Size of market for iPhones compared to size of market for iPhone ultrasound devices. Also, you'll need FDA approval in the US for their use.
For example, the FDA and other agencies are concerned with the effects of transmitting energy into the human body. Medical devices like ultrasound systems are not toys.
I don't mean to be harsh at all, but with respect, I question your assertions here.
And this post is a question because I don't know the answer, so I am just guessing (a lot). I hope someone with actual experience in getting FDA approval for a medical ultrasound machine actually reads it and answers, with how much it cost and what hoops they had to jump through.
In general, there are thousands of regulations that must be satisfied. Some specifications that must be met include ISO 13485, ISO 14971, IEC 60601 3rd Edition, IEC 62304, and probably ten more that I have forgotten about, such as RoHS, WEE, radiated emissions, etc.
The systems I worked with involved multilayer (16 layers plus) circuit boards, custom ASICs, FPGAs, ARM SOCs, etc., mixed OS (e.g., Windows CE and WindRiver, etc.)
The code base is large and complex, as you have not just ultrasound, but often, calculation packages of various kinds (cardiac, OB, etc.) These packages are expensive to develop and have to be carefully verified. If you're measuring the length of a fetal femur and translating the measured length to an estimated gestational age, you don't wish to be wrong. Same deal with cardiac output measurements, etc.
Then there is the whole issue of transducers. It's a complex field, and you have to deal not only with materials (some of which contain RoHS regulated elements, such as lead), but also, dicing saws (to cut the piezo), matching layers, transmission lines (to send signals to / from the transducer and the ultrasound machine front end.)
I'm not trying to be rude, or baffle you with a lot of jargon, it's just that my experience is that building a useful ultrasound machine is much more complex than it might appear from the outside of the industry, so to speak.
Finally, I think building an iPhone is probably even more complex, but the incredible volume of sales tends to make amortizing the cost more palatable.
I could be wrong, of course, and your comments are welcome.
Electronics wise, we are using a single element, mechanically translated (similar to the atl access pv10 probe) - then with a single element you can cut on the price (so far our prototype parts costs 250$/300$) while still giving a basic image for the user, who doesn't all the time need all the feature of a high-end ultrasound scanner =)
What do you think?
Do you think that a lot of that complexity would be reduced by opening it up to a wider development community through open source? How much open source, consumer electronics, were used? Did you source the transducers from another company, or make them in house?
Cheers again for the comment.
The post is necessarily incomplete; I don't think I can give you a full appreciation for all that is involved. And I don't wish to give the impression that ultrasound is necessarily more complex than other imaging modalities, such as MRI, PET, etc.
I wouldn't rule out open source, and many open source tools are used in the engineering process (e.g., gcc, git, etc.) I don't know about including open source components in a commercial code base, though. The lawyers usually ran away screaming whenever we would suggest using any open-source code.
Certainly the high-volume electronics industry makes components that are used in ultrasound systems. Some of the ARM SOCs, for example, and I suppose, some of the FPGAs, DSPs, etc. There are also a number of custom components, such as ASICs and combined analog-digital parts that show up in the so-called "front end."
The companies I have worked for designed their own transducers. That really is a science as well. Making a transducer probably involves at least 100 - 150 process steps, and some very expensive equipment (dicing saws, for example.) You also often have injection-molded parts (e.g., the transducer handle itself) that are expensive to produce (the molds for the injection molding machine are done with 3D solid modeling tools, then CNC machined from steel, etc.
You also have whole departments of people that work in "Regulatory Affairs" and/or "Compliance Engineering."
You also need to employ people to "optimize" your ultrasound images, in each of the different modes you might support: B-mode (2D), doppler, M-mode, color power doppler, etc. You also have things like harmonic imaging, etc.
Then there is sending images you have collected off to the various PACS systems that hospitals have. This usually involves a complex protocol known as DICOM.
Ok, I'm out of gas for this comment. Again, not trying to drown you in jargon, just suggesting that there is a reason that new ultrasound machines tend to be pricey; that reason is that NRE (non-recurring engineering) is very expensive, actually building the boards is expensive, shipping the systems and maintaining them in the field is expensive, and maintaining all of the other systems you have to have in place to be a viable ultrasound company is really expensive.
Hope this helps; thanks for letting me share a bit of my experience.
Once you see the uphill road, you realize you're better off starting from scratch and writing the product yourself instead of depending on OSS. For some noncritical aspects, it's fine, but then you get into the definition of "noncritical" :-)
It also depends on the class of your device (A, B or C in 62304 parlance) how much rigor you must put into your software process.
Ultimately it didn't matter much for our beauty product but it would be a big problem if we tried to use them for imaging.
At one point in time, I had a number of people in incoming receiving working for me. We had to do all kinds of quality control on incoming components, such as castings, PCBs, etc. We had automated measuring machines, etc. It's all very expensive to set this stuff up and staff it.
We also had to use an XRF gun on parts, to make sure we weren't being shipped non-RoHS parts.
As I remember, one of the add-ins for our Agile PLM system (Agile is an Oracle product) was on the order of a few hundred thousand dollars for licensing fees and setup, not counting the months of consulting time necessary to load bills of materials, etc., into the system.
Just to point out injection molding, 3D solid modelling, and CNC machining don't have to be super expensive these days.
Large volumes, and especially high end stuff... sure that takes a lot of up-front cost. But for smaller volumes (eg prototyping, short run) the costs are very reasonable now.
It seems due to continuing development of Open Source hardware and software in these fields, which created good virtous cycles for them. Hopefully this continues... :)
Note - saying the above as someone who's into 3D solid modelling and CNC machining already. Haven't gotten into injection molding yet, but it's on my personal ToDo list for not far off. :D
The fact that this company has to work with very low level components and that it had no spin-off on other areas is a market flaw, not something inherent on their devices.
Don't know if that'd the kind of thing or too basic?
And the interesting detail, in the article that the author links there is this opinion from the doctor who uses the portable ultrasound device:
"Other doctors often ask me if I bill for my exams. I don’t, because billing and the detailed documentation and posturing that would be necessary to prove to an insurance company that an ultrasound was necessary would take more time than I have."
The rest of the article is also insightful.
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.
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).
It seems very limited for purchase, but would be cool to get my hands on one. I added it to the post :)
There is a video series of a teardown/repair of an old baggage x-ray machine that was acquired this very way:
In fact, looking through the other videos by the same guy, he seems to have a fair number of xray machines..
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.)
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.
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.
I think it can be greatly improved by better software, so it get's closer to an MRI.
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.
The answer is that the market price reflects a lot of other costs than just parts for adding an incremental user.
Looks like they use one or just a few transducer and move it manually to reduce the cost.
Had to skip on that and just ate more fiber instead which thankfully solved that (pain was unbelievable).
> They wanted $600 to ultrasound
Well, they were asking that for the procedure, not for the device. The problem you had is, that you're probably living in a country with a laughable healthcare system. Guess what I did pay for my ultrasounds? Nothing, because it's covered by our mandatory insurance system. In fact most general practitioners have ultrasound machines (quite modern ones, too, I'd like to add).
after a few bad attacks over a couple years, it finally dawned on me to radically increase my fiber intake after reading up on it online
no attacks for years now
initially I had reduced my fat intake but now far less careful without any downsides
cannot imagine anything worse than gallstone attacks, I literally thought I was dying the first time it ever happened
I know that just too well. In case one ever happens to hit you again, I found out that a hot bath will give you instant relief. Don't ask me how it works exactly, I just found out, that it works.
Yeah, but actually you need an ADC that runs at MHz frequencies and a frontend amplifier to capture the signal and put it into the ADC
Definitely this falls into the "not expensive" category, but not in the "trivially cheap" one
160$ cost for a single electronic board, not cheap, not so expensive..
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.
- 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).
I met one of the original engineers for ultrasound. The original design was 3d through mechanical scanning of the body