There are many more desktop tools for debugging GPU code, largely because of game development. Xcode as an IDE is pretty out of date. Visual studio has much better debugging tools for GPUs. See nvidia's tools. As a long time GPU programmer, I'm particularly interested in testing out rust.
The medical industry moves slowly. Medical data is often covered by HIPAA, which is why it is often not available easily on the web. Using CDs is just an artifact of their slow movement through technology.
Oh interesting, I always read (on r/GraphicsProgramming) that XCode has some of the best debugging tools out there. That's the main reason it's been on my mind. I just need better debugging tools on Mac!
Unity and Unreal have industrial users, including medical.
You are really asking, “why does medical imaging not have budgets for software?” It faces all the same monetization challenges as all business to business software, that tends to, unfortunately, disfavor operationally cheap and performant solutions.
The medical industry moves slowly. Medical data is often covered by HIPAA, which is why it is often not available easily on the web. Using CDs is just an artifact of their slow movement through technology.