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Solid-state technologies are quietly disrupting the medical imaging industry. The solid-state medical sensor market is already worth $350M and is expected to reach $600M by 2022, at an 8.3% compound annual growth rate. (source: Solid-State Medical Imaging 2017 report, Yole Développement)

Zooming into the endoscopy market, digitalization is almost complete. CMOS sensor-based videoscopes are fighting with CCD-based endoscopes, promising improved image quality, increased flexibility and better reliability. This technology is opening up opportunities for newcomers in the endoscopy market. In this context, Yole Développement’s analysts interviewed Shingo Ishii, group leader of Fujikura’s medical business development division.

Yole Développement: Can you please explain Fujikura’s role in the development of fiber-optics in Japan and how the company got involved in fiber-optic bundles for endoscopy?

Shingo Ishii: Fujikura started optical fiber development in 1970 for telecommunication, and today Fujikura is one of the major optical fiber/fiber cable suppliers in the world. Through this long history, a variety of specialty fibers were developed as well, including image fibers. Image fibers have very unique configurations and state of the art production methods where tens of thousands of silica-based optical fibers are fused together as one small diameter fiber. Each fiber works as a pixel for image transmission through an optical lens. Due to their small diameter, from 160μm to 1500μm, the fiber is suitable for ultra-small diameter endoscopes used in urology, gynecology, ear, nose and throat, neurology, cardiology, respiratory, gastro intestine and small anatomies. Today, Fujikura supplies image fibers to most of the major endoscope manufacturers and is commonly used inside medical devices. Image fibers are well accepted in smaller endoscopes and will remain for decades.

YD: When did Fujikura decide to develop a cable assembly for small diameter videoscopes?

SI: Last decade there was strong demand for CMOS chip-on-the-tip endoscope development because CMOS chip technology had shrunk and offered better image quality. However, mounting the objective lens on the CMOS chip and assembling it with an electrical cable, while ensuring high reliability in large volume production needs special technology and experience. Through our 132 year company history micro assembly technology has been a strength, involving in-house manufactured cable and connectors. Fujikura can supply CMOS image sensor (CIS) modules consisting of lens, chip, cable and connector to medical device customers, either with 160K pixels, 400X400 resolution, offering 1.4mm over all diameter , or 40K pixels, 200X200 resolution, and 0.9mm overall diameter.

Fjikura at the heart of the videoscope transition Yole Interview April2017

Fujikura 160K(OD=1.6mm)  and 40K(0.65X0.65mm) CMOS imaging sensor module 40K CMOS imaging sensor module is smaller than a rice

YD: What are the key elements that differentiate Fujikura’s cable assemblies?

SI: Medical device development takes several years and device manufacturers need stable partners who have longer-term perspectives. Fujikura is a financially strong partner and the business is diversified in many fields, making it a very stable company. Through more than 30 years in the medical image fiber business, Fujikura understands industry requirements including sterilization, traceability, documentation and risk management. We can supply CIS modules with some options, including illumination, articulation, working channels and custom cables/connectors by utilizing our factories in the Asian region.

YD: What are the applications targeted by Fujikura’s cable assemblies?

SI: SI: Fujikura’s goal is supporting device manufacturers to make devices smaller and/or thinner for minimally invasive surgery to improve patients’ quality of life. Also, such small CIS modules can be applicable for visualized catheters and therapeutic devices to reduce blind device insertion.

YD: What value do videoscopes add compared to fiberscopes?

SI: Since the image fiber diameter is so small, the fiber is used for semi-rigid endoscopes, not competing with chip-on-the-tip applications. There is another type of fiber bundle with multi-component glass fibers used for flexible endoscopes. Chip-on-the-tip technology is sometimes compared with fiber bundle technology because both technologies are targeting flexible endoscopes. Chip-on-the-tip has several advantages over fiber bundle technologies. The most obvious advantage is smaller pixel size and the ability to accommodate more pixels in same area, so theoretically image quality is better. CMOS has good sensitivity so fewer light guide optical fibers are necessary, which makes endoscope diameters smaller. CMOS chips are connected through an electrical cable and very durable to repeated bending, whereas fibers start breaking after repeated bending, causing black dots in the image. Therefore, periodical refurbishment and repair is necessary and maintenance cost to the hospital remains high. CMOS technology keeps advancing, so more improvements can be expected in the near future.

Roadmap for small diameter videoscome Yole Fujikura April2017
YD: What is your opinion on single-use videoscopes and the applications they could target?

SI: Chip-on-the-tip videoscopes will become mainstream for single-use scopes in the near future. Besides the scope, non-visualized medical devices such as catheters or surgical tools will have visualization capability, as good image quality CIS modules shrink.
Compared with other visualization technologies, for example charge-coupled devices (CCD), CMOS technology’s advance is very noticeable, and will keep going. Pixel numbers are increasing in the smaller chip format due to miniaturization of pixel size. Sensitivity is improved with back-side illumination technology, so overall image quality has been improved even in smaller package sizes. Such CMOS chip advancements are achieved thanks to mobile phone technology advancements. Also, chip and wire assembly technology has improved and it makes such modules smaller, while retaining high reliability. Thus, CIS module technology will become the major technology for medical device visualization.
In terms of endoscopy applications, such miniature technologies are especially applicable to smaller areas such as the brain, sinuses, lungs, larynx, bile duct, and in mini-laparoscopy, gynecology and urology. Also, new technology opens up 3D scope miniaturization and multiple cameras for wider area diagnostics. New areas could be for catheters for example, feeding tubes, suction tubes, cardiac and ICU catheters.

Shinko FushikuraBio:

Shingo Ishii had learned international business through a collage in Vancouver, Canada and worked in Seattle, WA as a project leader, totally 10years. In 2002, he joined Fujikura LTD. of international marketing team of optical fiber components for telecommunication. Since 2007, he became a new business development manager of miniature CMOS imaging sensor module and specialty optical fiber in Medical industry.


Related report: Solid-State Medical Imaging 2017 - Advanced solid-state technologies are disrupting the medical imaging industry

Solid State Medical Imaging.pptx COVERKey features of the report:

- Overview of the selected solid-state technologies and trends for medical imaging modalities included in this report

- Market forecast for solid-state IC by modalities, as well as for the solid-state IC market (CMOS image sensors, a-Si TFT flat panel, CCD imagers, silicon photomultipliers, silicon photodiode array, etc.)

- Major players, supply chain, and mapping

- Market drivers and technology trends, by medical imaging modalities



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