Portable ultrasound devices: A method to improve access to medical imaging, barriers to implementation, and the need for future advancements

Medical imaging is crucial to all major levels of health care, as effective decision-making hinges on correct diagnoses. Although diagnostic imaging helps physicians in confirming, assessing, and documenting courses of various diseases and responses to treatment, as much as two-thirds of the world does not have access to basic radiology services due to strict infrastructural, educational, and financial requirements. Radiographic images and ultrasonography are able to meet over 90% of the imaging needs in primary care and emergency services, making them important diagnostic imaging modalities in rural areas. Limited accessibility to imaging modalities significantly impacts health outcomes and increases healthcare costs for marginalized patients through lengthy transportation to essential diagnostic technologies, delayed or inappropriate treatment, and missed diagnoses. Ultrasonography in particular is a core diagnostic tool while remaining one of the safest, as no radiation is involved. It is capable of providing rapid diagnoses of life-threatening disease such as cardiac failure, pneumothorax, cholelithiasis, abdominal organ injuries, fractures, skin cancer - which can now be imaged with >15 MHz units, as well as being able to monitor pregnancies. However, conventional ultrasound devices are often expensive and difficult to operate and maintain without appropriate scale and infrastructure. Perry et al. found that nearly 40% of ultrasounds in resource-limited countries are not fully functional, often because they are donated at the end of their lives and getting replacement parts is either not possible or a lengthy process.