Ultrasound system, a machine used by doctors to take images of internal body structures for diagnostic purposes is usually cart-based. Recently, the medical ultrasound innovation welcomes yet a new entry – Butterfly iQ – a mini ultrasound on-a-chip technology that connects to a smartphone, taking diagnostic ultrasound imaging to another level.

Meet the smartphone ultrasound scanner – the Butterfly iQ

Butterfly iQ is an ultrasound-on-a-chip which retains the basic principle of usual ultrasound system, while incorporating two new key things. Firstly, it replaces the piezoelectric crystal in usual ultrasound system with micromachine that acts like a tiny drum to generate vibrations. This allows a rather wide range of clinical applications as instead of tuning the crystal at the time of manufacture to produce the right type of ultrasonic wave for imaging at a particular depth, the Butterfly iQ can be tuned for different clinical applications at any time.

Secondly, this ultrasound on-a-chip has integrated circuits in which its micromachines are attached directly to a semiconductor layer that contains all the necessary amplifiers, signal processors and so on. That having said, everything can be found on just a single chip – inside the probe in this Butterfly iQ. This is very different from today’s ultrasound system with cables connecting each crystal to the computer that produces images.

By connecting Butterfly iQ to iPhone, the users can examine body area that they want anywhere anytime. The users just have to place the Butterfly iQ on that particular area, then a black-and-white ultrasound image will appear on his or her phone. The images generated from the chip would then be streamed to Butterfly’s cloud, and interpreted by a physician or eventually to the company’s artificial intelligence (AI)-based deep learning software. (The iQ system combines three transducers in one, the physician does not need to switch out transducers to conduct imaging on a different part of the body, saving valuable time. The images are then sent to the cloud for storage.)

Possible ‘own scanning’ raises worries among doctors

Butterfly iQ is easy and convenient to use, that patients can do their own scanning at home with this portable device in the future. This could accelerate treatment for people who tend to set aside their discomfort. A successful case of this device is that an American vascular surgeon, John Martin, MD, who successfully identified cancerous cells in his neck using Butterfly iQ. This allowed him to receive earlier treatment; and thus, saving his life.

However, as amazing as the technology sounds – this new ‘tool’ has since raised concerns among doctors. According to researches, although some emergency room doctors are experimenting with the portable ultrasound tools, the tools still remain unpopular among doctors. One of the reason for its unpopularity would be its inferior image quality to the usual ultrasound system.

The new system is only available to doctors and medical clinics. Photo credit: Butterfly Network/New Atlas
The new system is only available to doctors and medical clinics. Photo credit: Butterfly Network/New Atlas

“Even if they make the image better, the problem is misuse. For every John Martin story, there will be multiples of that which lead to more tests, more worries, and maybe even more risks, such as biopsies,” said Dr Eric Topol of Scripps Research Institute. He opined that if this technology were to use by the public, “all sorts of problems may arise”. False positive resulted from the technology may raise publics’ worries. Furthermore, this is a problem that AI might not be able to solve, at least at the moment.

Doctors also face difficulties in transmitting the images to the hospital’s database for storage, which is required to bill for the scan. In addition, if the device is to be used by the public, who does not have any relevant background, they may have difficulties in understanding the image. “Even most doctors are not good at reading ultrasounds. How are consumers going to?” asked Dr Eric Topol.

In spite it all, the announcement of the gadget securing a green light from the US Food and Drug Administration (FDA) is hoped to be able to put someone’s mind at ease. Butterfly’s iQ is cleared for diagnostic imaging in 13 clinical applications, including musculoskeletal, cardiac and peripheral vessel applications. This is the broadest FDA clearance to date for an ultrasound transducer.

“By removing the barrier of price, I expect Butterfly to ultimately replace the stethoscope in the daily practice of medicine. We can now provide a diagnostic system to address the millions of children that die of pneumonia each year and the hundreds of thousands of women that die in childbirth, and these are just two examples of the impact this technology will have,” remarked Martin, who is Butterfly’s chief medical officer. MIMS

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