P Tortoli, T Loupas, R Peterson, S Freear, F Guidi, E Boni, A Ramalli
Medical ultrasound (US) imaging is undergoing rapid evolution driven by continuous advances in diagnostic methodologies and instrumentation. This progress is deeply rooted in the synergy between microelectronics advancements and US physics. This paper provides a comprehensive assessment of the influence of modern microelectronic devices (including Analog Front-End integrated circuits, Digital Signal Processors, Field Programmable Gate Arrays, and Graphics Processing Units) along with high-performance computing architectures, on the development of US medical imaging systems technology. Two representative case studies are examined to illustrate the evolution of fundamental building blocks: the beamformer and the Color Doppler flow imaging module. The analysis highlights how these blocks have leveraged over four decades of progress in microelectronics and computational technologies to achieve substantial improvements in imaging performance and introduce breakthrough functionalities, such as real-time imaging at frame rates of some kilohertz. The discussion emphasizes the role of dedicated hardware resources in supporting real-time implementation of transformative imaging methods. Finally, prospective research directions are outlined, with emphasis on the anticipated impact of next-generation digital integration trends on US system design.