Roxanne Nelson, RN, BSN
November 10, 2017
Vascular surgeon John Martin, MD, had been experiencing an uncomfortable sensation in his throat.
Coincidentally, Dr Martin had been testing a pocket-sized ultrasound device that was being developed by Butterfly Network, a startup based in Guilford, Connecticut. He had recently been hired by Butterfly as their chief medical officer, so the timing couldn't have been more perfect.
"I felt something 'funny' in my neck, and I connected the probe to my phone, did an ultrasound, and there it was ? my tumor," explains Dr Martin in a video on the company website.
Using his iPhone to view the imagery, Dr Martin immediately zeroed in on a 3-cm mass on his throat, which turned out to be squamous cell cancer.
Although he saw the mass in his neck, he needed to undergo a biopsy for a definitive diagnosis. But the small, handheld imaging device let him know that the mass was there and needed attention.
"I was waiting in the doctor's office to get a diagnosis, I was waiting to get surgery, I was waiting to get radiation therapy ? and then it came to me ? it's all about time," he said. "Because the sooner we get a diagnosis, the sooner we can get treatment."
With this device, "we're conquering time," he pointed out. "We didn't invent an ultrasound machine, we've invented a time machine. We've hastened the time to diagnosis, and when you hasten the time to diagnosis, you hasten the time to treatment and getting better."
He noted that there were many times during his practice that he had to relay less than positive news to a family and had told them, "If only I had gotten there sooner."
The device, called the Butterfly iQ, is the first solid-state ultrasound machine to be marketed in the United States. Conventional ultrasound works by using a vibrating crystal to generate sound waves, whereas the iQ uses capacitive micro-machined ultrasound transducers ? tiny ultrasonic emitters that are layered on a semiconductor chip barely larger than a postage stamp.
The device is about the size of an electric razor and plugs into the iPhone's Lightning port. It sells for $1999, a fraction of the cost of a full-sized ultrasound machine. The images aren't of the same quality as those produced by high-end ultrasound machines, but there are advantages. For example, emergency department physicians can carry one in the pocket of their scrubs and have it immediately available at the bedside.
"The impediment to doing an ultrasound right now, in any emergency department, has been access to the machine," said J. Christian Fox, MD, professor of clinical emergency medicine, University of California, Irvine, School of Medicine, who is a medical adviser to the company. "But having it in your pocket ? there are no more excuses."
In addition, explained Dr Fox, you only need one transducer to look at structures in the near field and those deeper inside the body.
The company says that medical imaging should be accessible to everyone on the planet, and a small, inexpensive device such as this one could make imaging more accessible in developing nations. The investment would be $2000 plus the cost of an iPhone, whereas a full-scale ultrasound machine may cost $100,000 or more.
The Butterfly iQ has received 510(k) clearance from the US Food and Drug Administration for diagnostic imaging involving the following 13 clinical applications: adult cardiology; pediatric cardiology; fetal/obstetric conditions; gynecologic conditions; conventional musculoskeletal conditions; superficial musculoskeletal conditions; pediatric conditions; peripheral vessels; procedural guidance; small organs; and urologic conditions.
Currently, it is intended to be used by healthcare professionals, but use by patients may be just down the road. In two upcoming studies, patients will be using the devices, but according to Jonathan Rothberg, an entrepreneur who founded Butterfly, it will be a while before it moves out from the realm of healthcare professionals.
It is not intended to replace a visit to the doctor, nor is it meant as a substitute for appropriate medical care. Dr Martin pointed out that when he found the mass in his throat, he didn't fire his doctor. Rather, it alerted him to a problem that subsequently turned out to be cancer. This tool, he believes, may give the patient more information and thus make the doctor's visit more efficient.
Not everyone is enthusiastic about the device. According to Forbes magazine, Eric Topol, MD, editor-in-chief at Medscape, said on Twitter that he had tried using an earlier version of the device and was unimpressed. On Twitter, he wrote, "the image quality isn't competitive at this point."
SOURCE: Medscape, November 10, 2017. Surgeon Detects His Own Tumor With iPhone/Ultrasound Device