Tag Archives: 4D ultrasound

6 Ultrasound Trends to Watch in 2025

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The field of ultrasound technology is rapidly evolving, with advances that promise to reshape diagnostic imaging and patient care. As we begin 2025, several exciting trends are emerging, driven by breakthroughs in artificial intelligence, portability, and precision imaging. Here, we explore six ultrasound trends that are set to make waves in the medical field in 2025.

1. AI-Powered Ultrasound Diagnostics

Artificial Intelligence (AI) is transforming ultrasound imaging by automating complex tasks and enhancing diagnostic accuracy. In 2025, we expect AI to play a central role in streamlining workflows.

AI algorithms are increasingly capable of analyzing ultrasound images to detect and measure abnormalities, such as tumors, cysts, or cardiovascular issues, with speed and precision. These systems can assist practitioners in diagnosing conditions at an earlier state, reducing the risk of misdiagnosis. Moreover, real-time AI guidance is being integrated into portable devices, making it easier for clinicians to perform and interpret scans in remote or underserved areas.

For example, machine learning models are being trained to help ultrasound practitioners evaluate fetal development, monitor chronic diseases, and even predict patient outcomes. As these tools become more accessible, AI-driven ultrasound diagnostics will help address global disparities in healthcare delivery.

2. Therapeutic Ultrasound

Beyond diagnostics, ultrasound is increasingly being used for therapeutic purposes. Therapeutic ultrasound employs high-intensity sound waves to treat a variety of medical conditions by delivering targeted energy to tissues.

Applications of therapeutic ultrasound include treating kidney stones, fibroid, and prostate disease, as well as enhancing drug delivery and alleviating chronic pain. Focused ultrasound therapy is also making significant strides in oncology. It’s used to ablate tumors non-invasively using either thermal or mechanical effects and the latter has been found to also promote abscopal immune responses. Additionally, this technology is showing promise in neurology, with research exploring its potential to treat conditions like Parkinson’s disease, addiction, and depression by stimulating specific areas of the brain.

As the technology continues to advance, therapeutic ultrasound offers a noninvasive alternative to traditional surgical procedures, reducing recovery times and minimizing risks. In 2025, look out for this application as it gains more widespread adoption in both clinical and research settings.

3. Miniaturization and Portability

Portability is becoming a common feature of next-generation ultrasound devices. Compact and lightweight handheld units are set to become even more powerful in 2025, enabling point-of-care imaging in ways that were unimaginable just a decade ago.

These miniaturized devices are equipped with wireless capabilities, allowing clinicians to transmit data seamlessly to cloud-based platforms or electronic health records (EHRs). In emergency situations, paramedics and first responders can use portable ultrasound to assess internal injuries on-site, significantly improving patient outcomes.

Additionally, this trend aligns with the growing focus on telemedicine. Patients in remote or rural areas can now benefit from real-time imaging performed by trained technologists and reviewed by specialists miles away.

4. High-Resolution 3D and 4D Imaging

The demand for high-resolution imaging is pushing the boundaries of 3D and 4D ultrasound technology. By 2025, these systems will deliver clearer, more detailed images, providing clinicians with enhanced diagnostic capabilities.

4D ultrasound, which adds the dimension of time to 3D imaging, is especially beneficial in fields like obstetrics, where it offers real-time visualization of fetal movements. Beyond obstetrics, high-resolution imaging is proving invaluable in cardiology and oncology, enabling practitioners to visualize complex structures such as heart valves or tumor margins with greater clarity. This technology also bridges the gap and allows for greater reliability of mutual registration between ultrasound and MRI, CT, and PET.  

Image resolution improvements are accompanied by generally more affordable ultrasound technology overall, making sonography a first radiologic assessment tool accessible to smaller clinics and facilities worldwide.

5. Integration With Wearable Technologies

Wearable devices are stepping into the ultrasound space, promising to revolutionize how and where imaging is conducted. These devices, which can be worn as patches or integrated into clothing, are designed to provide continuous monitoring of specific conditions.

In 2025, you may see wearable ultrasound being used for applications like tracking cardiovascular health or monitoring chronic conditions such as kidney disease. For instance, a wearable device could continuously measure blood flow or detect abnormalities in real time, alerting healthcare providers to intervene in a timely manner.

This trend aligns with the broader movement towards personalized medicine, where patients take a proactive role in their healthcare with the help of smart technologies.

6. Expanded Use of Contrast-Enhanced Ultrasound (CEUS)

Contrast-enhanced ultrasound (CEUS) is gaining traction for its ability to improve visualization of blood flow and tissue vascularity. Unlike traditional ultrasound, CEUS uses microbubble contrast agents that provide detailed imaging without exposing patients to ionizing radiation or iodinated contrast material.

In 2025, CEUS is expected to find broader applications, particularly in oncology and cardiology. It is being used to assess heart function more accurately, differentiate between benign and malignant lesions, monitor the efficacy of cancer treatments, and has therapeutic applications. The latter is a unique demonstration of ultrasound having both diagnostic and therapeutic indications. 

The noninvasive nature of CEUS, combined with its diagnostic precision, is making it a preferred option for patients and providers alike. As regulatory approvals expand and more clinicians are trained to use this technology, CEUS will likely become a standard in advanced diagnostic imaging.

Conclusion

Ultrasound technology is undergoing a renaissance, driven by advances in electronics, miniaturization, portability, and imaging algorithms, including AI. As we move into 2025, these trends are set to enhance diagnostic capabilities, improve patient outcomes, and make imaging more accessible than ever before.

For healthcare providers and institutions, staying ahead of these trends will be critical in delivering cutting-edge care. Whether through adopting AI-powered solutions or CEUS, integrating wearable devices, or exploring new techniques like therapeutic ultrasound, the future of ultrasound is brighter—and more innovative—than ever.

Therese Cooper, BS, RDMS, is a sonographer and the Chief Learning Officer at the American Institute of Ultrasound in Medicine.

Ultrasound-Guided Cancer Imaging: The Future of Targeted Cancer Treatment

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Tumor margins and malignant grade are best defined by vascular imaging modalities such as Doppler flow or contrast enhancement combined with videomicroscopy. The following are image-guided treatment options that can be performed on breast, prostate, liver, and skin cancers.

NEW DOPPLER APPLICATIONS

Blood vessel mapping using the various Doppler modalities is routinely used in both cancer treatment and reconstructive planning. In cancer surgery, it is critical to locate aberrant veins or arterial feeders in the operative site so postoperative blood loss is minimized. Advanced 3D Doppler systems allow for histogram vessel density measurement of neoplastic angiogenesis.

VESSEL DENSITY INDEX

(Fig 1) Baseline neovascularity is a treatment surrogate endpoint and therapy is maintained, increased, or suspended based on quantitative angiogenesis data.

SOLID ORGAN CANCER IMAGING UPDATES

Breast cancer, invading the lower dermis and nipple, discovered with high-resolution probes signifies the tumor has outflanked clinical observation essential for detecting the newly discovered entity of breast implant-associated anaplastic large cell lymphoma (BIA-ALCL). This capability is also vital for diagnosing the recent epidemic of male breast cancers arising near the mammographically difficult nipple areolar complex, occurring in our 911 First Responders.

For prostate cancer, 4D ultrasound can identify low-grade cancer delimited by the capsule and with low vessel density, and should be followed serially at 6-month intervals.

CONTRAST-ENHANCED ULTRASOUND (CEUS)

In 1990, Dr. Rodolfo Campani developed ultrasound contrast for liver imaging and Drs. Cosgrove (London) and Lassau (Paris) extended the use to breast, skin, and prostate tumors. CEUS is currently used worldwide but is not Food and Drug Administration (FDA)-approved in the United States.

One use for CEUS is microbubble neovascularity, which demonstrates therapeutic response since the Response Evaluation Criteria in Solid Tumors (RECIST) studies noted tumor enlargement during treatment might be related to cell death with cystic degeneration or immune cell infiltration destroying malignant tissue. Doppler ultrasound or CEUS reliably verifies decreased angiogenesis in place of contrast CT or dynamic contrast-enhanced (DCE) MRI. If vascular perfusion ceases, thermal treatments, such as cryotherapy, high-intensity focused ultrasound (HIFU), or laser ablation, should be completed.

Four-dimensional (4D) ultrasound imaging is real-time evaluation of a 3D volume so we can show the patient immediately the depth and the probability of recurrence. Specific echoes in skin cancer generated by nests of keratin are strong indicators of aggression and analyzed volumetrically. Highly suspect areas are checked for locoregional spread and a search is performed for lymphadenopathy so we can determine if the disease is confined and whether further surgical intervention is unlikely at this time. Patients are reassured because they simultaneously see the exam proceed in systematic stages. In serious cases, the patient is forewarned that the operation involves skin grafts and tissue construction.  4D ultrasound permits image-guided biopsy of the most virulent area of the dermal tumor and allows the pathologist to focus on the most suspicious region of the lymph node mass excised from the armpit, neck, or groin. Some laboratories are using postop radiography and sonography for better specimen analysis.

VIDEO DIGITAL MICROSCOPY VS BIOPSY

Fear of complications can deter patients from seeking medical opinion and surgical intervention, so many opt for noninvasive options. Imaging can help to reduce unnecessary biopsies because it can help identify the 1 out of every 33,000 moles that is malignant, while weeding out those that are not.

Once skin cancer is diagnosed, the treatment depends on depth penetration, possibly involving facial nerves, muscles around the eye and nasal bone or ear cartilage. Verified superficial tumors are treated topically or by low dose non-scarring radiation. Many cancers provoke a benign local immune response or coexistent inflammatory reaction that simulates a much larger area of malignancy, and cicatrix accompanies the healing response. 4D imaging combined with optical microscopy (RCM (reflectance confocal microscopy) or OCT (optical coherence tomography)) defines the true border during surgery, sparing healthy tissue, resulting in smaller excisional margins and less scar formation.

 

Do you have any tips on incorporating ultrasound in cancer imaging? Comment below, or, AIUM members, continue the conversation on Connect, the AIUM’s online community.

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Robert Bard, MD, DABR, FASLMS, currently runs a private consulting practice in New York City. He authored Image Guided Dermatologic Treatments, Image Guided Prostate Cancer Treatment, and DCE-MRI of Prostate Cancer and is a member of multiple leading international imaging societies. Since 1972, Dr. Bard has pioneered digital imaging technologies as alternatives to surgical biopsies for dermatologic and solid organ neoplastic disease.