Where medtech value is moving: ultrasound, imaging AI and Europe's slow market
Siemens keeps the procedure, drops the cart
Siemens Healthineers has stopped selling the ultrasound carts most hospitals know. It kept the ones built for procedures.
A cart is planned for replacement every 7 to 9 years. A procedure earns every time it's done.
On 12 October it ended sales of Acuson Sequoia, Redwood, Juniper and Maple.
It keeps Acuson Origin, the P500 intracardiac echo (ICE) system and the wireless Freestyle. Siemens sells them with software and catheters, mainly to heart teams.
In my clinic, a scan tells me what to do next.
In an ablation, the ICE image can guide the catheter while the treatment happens.
Sourabh Pagaria, head of Ultrasound, put it simply: imaging "is increasingly becoming part of therapy, not just diagnosis."
Reuters puts the whole ultrasound business at a little over €600m revenue in 2025, 9% of the Precision Therapy segment.
Siemens says general imaging is well served by several established providers.
A spokesperson said that despite significant investment, the market is highly competitive and the company couldn't hold its own against large and emerging providers.
Procedure volume points the same way.
MedTech Dive reports Boston Scientific's electrophysiology sales rose 74.6% in 2025, to $3.33bn, and were still up nearly 24% in Q1 2026.
That's catheter money, not imaging money. But it shows where cases are heading.
Three days before Siemens' move, China's Midea completed its takeover of Italy's Esaote, an ultrasound and MRI maker with about €267m in 2025 revenue.
Same market, opposite bets, in the same week.
My read for founders and investors: value is moving to where the image shapes the treatment and is paid for case by case. In the general cart, scale decides. In the procedure, a place in the workflow decides.
For hospitals, the installed base is covered.
Siemens Healthineers promises "full lifecycle support", including maintenance, software updates and transducer availability.
Next step: ask for the end of support date for each system and transducer, in writing, at your next service review.
That applies to every vendor.
Canadian radiologists' guidance, cited by the European Society of Radiology, puts ultrasound life expectancy at 7 to 9 years depending on use. Many systems bought before 2020 are at or past that age, so each replacement belongs in the capital plan.
For replacements due from 2028, timing helps. In England, NHS Supply Chain published the tender for its next equipment framework on 28 September. Imaging ultrasound is in scope, with a start expected in April 2028.
In the Gulf, central buyers such as NUPCO in Saudi Arabia and PureHealth's Rafed in the UAE contract for many government hospitals at once. Support dates in one agreement can protect every site.
Europe's medtech: record jobs, slower market
Europe's medtech industry is hiring at record levels. Europe's share of world medtech spending keeps falling.
MedTech Europe's Facts & Figures 2026, published last week, puts direct employment at more than 950,000, a record. (The report's "Europe" means the EU27 plus Norway, Switzerland and the UK.)
The demand side looks different. Europe's medical device market accounts for 25.6% of the world market at manufacturer prices, down from 26.4% a year earlier and close to 29% in 2015. The US market is 47.6%. Europe's market grew 1.8% in 2025, against a ten-year average of 5.6%. And for the first time in the report's history, the number of medtech companies fell, from over 38,000 to over 36,000.
So Europe is still buying. Its spending is just growing more slowly than the rest of the world's.
Some caution is due. MedTech Europe is an industry association making the case for reform, and much of its own explanation is regulatory: the revision of the MDR and IVDR was still under negotiation as the report went to press. The fall in company numbers is driven largely by Germany, the report notes. Most countries were stable or slightly up. And 1.8% is one year's figure.
The part I keep coming back to is valuations.
Around 90% of European medtech companies are small or medium-sized, the report says, and for a small company the home market usually comes first. If that market keeps growing at a third of its usual pace, their sales take longer, runways stretch and rounds get harder. I suspect some are already being priced on how slowly Europe buys, rather than on what their devices do for patients.
The funding numbers point the same way. A 2024 Deloitte and MedTech Europe study found that European medtech raised $2.1 billion in venture capital in 2021, against $6.7 billion in the Americas, and concluded that the gap hampers scale-up for medtech start-ups.
For an investor, that cuts both ways. Some companies are slow for good reasons. Thin evidence. A product clinicians never asked for. A reimbursement case that doesn't add up.
I'd start with the clinical evidence. Solid outcome data and reimbursement secured in at least one European country, with slow uptake elsewhere, points to the market. Thin evidence everywhere points to the product, and a new geography won't fix that.
Telling the two apart is central to our healthcare work at NordGulf Alliance, where we pressure-test a company's clinical evidence and commercial case before capital or a health system commits. In my view, only the first kind of company should be looking at the Gulf as a second home market, and for those companies the Gulf can be the place where the price finally catches up with the evidence.
Imaging AI enters consolidation
GE HealthCare’s plan to acquire icometrix is a clear signal that imaging AI has moved into its consolidation phase. AI is no longer an add on it is becoming part of the diagnostic foundation.
Embedding icobrain’s quantitative MRI analysis directly into scanner workflows means clinicians receive consistent, decision ready information the moment the scan completes.
This matters because diagnostic quality varies widely.
When AI supports acquisition and standardises analysis, clinicians work from clearer, more reproducible inputs. It doesn’t replace expertise , it strengthens the foundation on which expert judgement depends.
Across healthcare, we’re seeing the same priorities emerge:
• regulatory assurance
• real-world evidence from multi-centre use
• seamless workflow integration
• and measurable clinical impact
And although this announcement focuses on neuroimaging, the direction of travel is broader. Similar integration is happening in ultrasound, point-of-care imaging and other frontline diagnostics as quality becomes embedded into the scan itself , not added afterwards.
My work centres on ensuring that these AI generated insights translate into safe, practical clinical decisions: validating performance in real settings, aligning outputs with pathways, and ensuring that the information clinicians receive is interpretable and actionable.
When every scan becomes reliable, every decision becomes clearer.
Reference to article: GE HealthCare to acquire icometrix
Company Announcements
What it means
The direction is clear across the three pieces. Value is moving to where the image shapes the treatment and fits the workflow, and European companies with strong evidence but a slow home market may find their price catches up in the Gulf.