WHAT IS PIUR IMAGING?

Turning Conventional Ultrasound into Intelligent, Reproducible 3D Tomographic Imaging

By: Lennard M. Goetze, Ed.D

 

“Ultrasound is an incredible modality—but it is still highly dependent on the person operating the machine. Everybody measures differently, documents differently, and that lack of consistency is the core problem we are solving.” — Robert Bauer, CTO & Co-Founder, PIUR IMAGING

 

HealthTech Reporter and AngioResearch recently met with Tullio Giannitti (General Manager, U.S.) and Robert Bauer (CTO & Co-Founder) of PIUR IMAGING, a company redefining how ultrasound is acquired, interpreted, and trusted. PIUR IMAGING is not building another ultrasound machine. Instead, it has created a powerful upgrade layer—a combination of hardware sensors, advanced software, and AI—that transforms existing 2D ultrasound systems into 3D tomographic imaging platforms capable of producing objective, reproducible volumetric data.

In an imaging field long challenged by operator dependency, workflow variability, and inconsistent documentation, PIUR IMAGING’s approach represents a structural evolution rather than an incremental improvement.

 

 

Prologue from THYROIDSCAN.org

By Dr. Angela Mazza, DO, ABAARM, FAAMFM, ECNU
 and Dr. Robert L. Bard, MD, DABR, FAIUM, FASLMS

In thyroid care, precision is not a luxury—it is essential. The thyroid is a small, dynamic organ whose structure, volume, vascularity, and nodular changes can signal metabolic imbalance, autoimmune disease, toxic exposure, or early malignancy. Yet for decades, thyroid ultrasound—despite being the gold standard—has remained vulnerable to variability in acquisition, measurement, and interpretation.

From our combined perspectives in endocrinology and diagnostic imaging, the future of thyroid assessment depends on reproducibility and longitudinal validation. PIUR IMAGING addresses this need by transforming conventional ultrasound into standardized 3D tomographic datasets that can be measured, revisited, and compared over time. This shift is particularly important in thyroid disease, where subtle volumetric changes, nodule growth patterns, and treatment response must be documented objectively rather than inferred subjectively.

For the endocrinologist, consistent thyroid volumes and automated nodule measurements offer a clearer framework for clinical decision-making—whether monitoring Hashimoto’s thyroiditis, evaluating nodular disease, or assessing response to medical, ablative, or lifestyle interventions. For the imaging specialist, volumetric ultrasound provides a durable record that supports follow-up, multidisciplinary review, and research validation.

What makes PIUR IMAGING especially compelling is that it enhances—not replaces—the ultrasound systems clinicians already trust. By adding intelligent sensing and software-driven standardization, it reduces operator dependency while preserving real-time imaging, patient safety, and accessibility. In thyroid imaging, this means fewer inconsistencies, more reliable baselines, and greater confidence in longitudinal care.

We view this technology not as an endpoint, but as an enabling platform. Once thyroid ultrasound becomes truly reproducible and quantitative, it opens the door to deeper understanding of autoimmune progression, environmental influences, metabolic correlations, and treatment efficacy—without radiation or invasive procedures.

Progress in thyroid care depends on our ability to see clearly, measure accurately, and validate responsibly. PIUR IMAGING represents an important step toward that goal, advancing ultrasound from a moment-in-time examination into a reliable, longitudinal tool for both clinical practice and scientific inquiry.

 

 MedTech Feature News

The Core Problem in Ultrasound Today

Ultrasound remains one of the most versatile, accessible, and safest imaging modalities in medicine. Yet it carries a fundamental limitation: its quality and reliability are heavily dependent on the skill and technique of the operator. Two clinicians scanning the same patient can produce different images, measurements, annotations, and reports. This variability limits ultrasound’s ability to serve as a truly quantitative, longitudinal, and reproducible diagnostic tool—especially in applications such as thyroid disease, vascular imaging, and treatment monitoring.

Robert Bauer summarized this challenge succinctly during the meeting: ultrasound is powerful, but “everybody is measuring in a different way, documenting in a different way. It’s not consistent. You have to trust the person who’s scanning”  PIUR IMAGING was founded to solve exactly this problem.

 

How PIUR IMAGING Works: From 2D Slices to 3D Tomography

At the heart of PIUR IMAGING’s innovation is a small, attachable motion sensor that clips onto virtually any ultrasound probe—regardless of manufacturer or frequency. This sensor tracks the probe’s movement during a sweep, while PIUR IMAGING’s software simultaneously captures standard B-mode ultrasound images from the host system.

The result is a tomographic 3D volume reconstructed from a simple sweep lasting approximately 20–30 seconds. Unlike traditional ultrasound protocols that require multiple static images in multiple planes, PIUR IMAGING relies on a single standardized transverse sweep, dramatically simplifying acquisition while expanding the dataset.

“We are not an ultrasound company. We take the ultrasound system you already have and turn it into a 3D tomographic imaging device.”

-Robert Bauer

The system then reconstructs the anatomy into a multi-planar 3D dataset, producing transverse, longitudinal, and coronal views—similar in concept to CT or MRI visualization, but without radiation or contrast agents .

 

AI-Driven Measurement, Annotation, and Reporting

Once the 3D volume is created, PIUR IMAGING’s AI algorithms take over. Measurements are automatically generated, calipers are placed consistently, and anatomical structures—such as thyroid lobes and nodules—are identified without manual intervention. Crucially, this automation does not remove clinician control. Users can adjust measurements if desired, but the baseline consistency is established by the system itself. The software also applies standardized classification frameworks (such as thyroid nodule risk scoring), generates annotated screenshots, and compiles a complete diagnostic report that can be automatically sent to PACS.

According to Bauer, this approach has demonstrated a reduction of scan-to-reporting time by up to 60% compared with conventional 2D ultrasound workflows, while simultaneously increasing reproducibility and documentation quality

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Why PIUR IMAGING Is an Upgrade—Not a Replacement

A defining philosophy behind PIUR IMAGING is that it does not compete with ultrasound manufacturers. Instead, it enhances their systems. Clinics do not need to replace capital equipment or retrain staff on entirely new platforms. The PIUR sensor and software integrate with existing machines, probes, and clinical workflows.

This “upgrade adapter” model is particularly compelling in a healthcare environment where budgets are constrained, yet expectations for quantitative imaging are rising. As discussed in the meeting, PIUR IMAGING is already integrated with major OEMs in Europe and is actively expanding partnerships in the U.S., positioning itself as a universal 3D intelligence layer for ultrasound rather than a proprietary ecosystem

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Current Clinical Focus: Thyroid Imaging

In the United States, PIUR IMAGING currently holds FDA clearance for thyroid imaging, making this its primary clinical application domestically. This focus is strategic: thyroid disease demands precise volumetric measurement, longitudinal comparison, and consistent nodule characterization—areas where traditional ultrasound struggles most.

The ability to generate reproducible 3D thyroid volumes allows clinicians to objectively track disease progression, response to therapy, or post-ablation outcomes. It also supports documentation necessary for reimbursement, research validation, and multi-disciplinary collaboration.

While elastography and Doppler imaging are not currently part of PIUR’s workflow—due to the physics of sweep-based acquisition—the company emphasizes that high-resolution B-mode tissue signatures alone can yield valuable diagnostic insights, particularly when standardized and quantified across time.

Beyond Thyroid: A Platform with Broad Potential

Although FDA clearance in the U.S. is currently limited to thyroid applications, PIUR’s technology is already approved for multiple indications in Europe, including vascular, abdominal, and musculoskeletal imaging. During the discussion, Bauer and Giannitti emphasized that the platform itself is agnostic to anatomy—the limiting factor is regulatory focus, not technical capability.

From carotid plaque assessment to breast imaging, liver evaluation, dermatologic structures, and even ophthalmic applications, the ability to generate reproducible 3D ultrasound volumes opens new avenues for research and clinical standardization. This makes PIUR particularly attractive to academic centers, research institutes, and innovation-driven practices seeking to expand ultrasound’s role beyond point-in-time visualization.

 “Thyroid imaging is our primary FDA-cleared application in the U.S., but the platform itself is designed for far broader clinical use.”— Tullio Giannitti, General Manager (U.S.), PIUR IMAGING

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Why the Imaging Industry Needs This Now

The imaging industry is at an inflection point. AI, value-based care, and longitudinal disease monitoring demand quantitative, reproducible data—not just images. CT and MRI already operate in this paradigm. Ultrasound, despite its advantages, has lagged behind due to variability and documentation challenges.

PIUR IMAGING directly addresses this gap by converting ultrasound into a measurable, reviewable, and shareable 3D dataset. It reduces dependence on operator technique, improves efficiency for high-volume practices, and enhances accuracy for treatment-focused clinicians. Importantly, it does so without increasing patient risk, cost, or workflow burden.

As Bauer stated, PIUR’s mission is to make ultrasound “reproducible and more comprehensive,” transforming it from an art form into a standardized diagnostic science .

A Structural Advancement, Not a Gadget

What distinguishes PIUR IMAGING is not a single feature, but a system-level rethinking of ultrasound acquisition. By layering intelligent sensing, AI reconstruction, and automated reporting onto existing hardware, PIUR elevates ultrasound to meet modern clinical and research expectations.

For imaging specialists, endocrinologists, surgeons, and researchers alike, PIUR represents a practical and scalable pathway to the future of ultrasound—one where 3D, objectivity, and reproducibility are no longer optional, but standard.

 

 

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