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Startup Aims to Bring Ultrasound Imaging to the Masses with Handheld, Low-Cost System

The Butterfly iQ uses ultrasound-on-a-chip technology and artificial intelligence to make diagnostic imaging more accessible and cost-efficient.

Meeri Kim, Contributor
Tue, 03/20/2018


Image courtesy of Butterfly Network, Inc.


Entrepreneur Jonathan Rothberg believes that miniaturization drives revolutions in industry -- specifically when devices are shrunk to the point where they can exist on a semiconductor chip. Putting a camera on a chip turned almost all cellphone-wielding citizens into prolific photographers, for example. Putting a computer on a chip brought the technology out of enormous rooms attended by specialists and into ordinary homes and offices.

Rothberg is primarily known as the inventor of semiconductor chip-based DNA sequencers, founding and selling two companies based on the technology. His latest venture, the Guilford, Connecticut-based Butterfly Network, aims to revolutionize medical imaging with its iQ device: a relatively low-cost, hand-held ultrasound tool that employs artificial intelligence for image acquisition and analysis.

The Butterfly iQ takes advantage of “ultrasound-on-a-chip” technology, which is fundamentally different from the technology that drives traditional ultrasound systems. Typically, ultrasound transducers are made of piezoelectric crystals that convert electrical pulses into mechanical vibrations. The iQ replaces these crystals with tiny devices called capacitive micromachined ultrasound transducers (CMUTs) that are fabricated in large arrays and integrated with supporting electronic circuits on a semiconductor chip.

“Putting DNA sequencing technology on a chip made it low-cost, so the idea was to start a company that would put ultrasound on a chip,” said Rothberg. “That would make it 50 times less expensive -- so instead of costing $100,000, it would cost under $2,000.”

In October, the device received FDA 510(k) clearance for 13 clinical applications including cardiac and fetal/obstetric imaging. Butterfly Network is currently taking preorders at a price point around $2,000 and will begin shipping in a few months.

Besides its cost, the iQ should be easy to use, according to Butterfly, which they hope will make high-quality diagnostic imaging accessible to anyone. The first site to formally test the system is an Annapolis, Maryland, nonprofit called the Heart Health Foundation that operates a free vascular screening program, Dare to C.A.R.E. The three-part study focuses on identifying aortic aneurysms in older adults. First, a skilled technician will compare images taken by the Butterfly iQ to those taken by a commercially available ultrasound device. Then, a novice user will use the device to perform screenings. Finally, the patients themselves will image their own aortas.

According to Butterfly Network Chief Medical Officer John Martin, who is also co-founder of the Heart Health Foundation, the first phase of the study is nearly over. They plan to start the second phase in about two months. Martin said he is not present when the images are captured or read and a third party will review the images and data.

Butterfly Network also has other projects lined up that will focus on heart failure, obstetrics, pediatric pneumonia, and kidney stones.

“Cardiovascular disease is the number one cause of death in the country, so it’s an ample opportunity where care can be made better,” said Martin. “It’s a major expense for the economy, and we believe our device has the potential to change that.”

The artificial intelligence component -- specifically, deep learning algorithms -- is built into the system for two applications. The first is as an image acquisition assistant to guide inexperienced users to collect a suitable image. The second is to analyze the image. According to the company, the same basic algorithms can be trained for a wide range of specific clinical applications by Butterfly Network engineers, and the device learns more with every use.

Brian Choi, an associate professor of medicine and radiology at George Washington University, is intrigued by the Butterfly iQ but has questions about the device's capabilities. For instance, will the iQ have as long of a lifespan with heavy use as traditional systems? Also, in his experience, miniaturization tends to limit the number of features available to a physician.

“The hand-held ultrasound devices of tomorrow will have the best features of echocardiograms from yesterday,” said Choi. “You can't load in all the most advanced features of today's ultrasound.”

He does note that the iQ's low price point will undercut other hand-held ultrasound devices, which typically sell for $7,000 to $8,000. Mobisante, GE, and Philips all have their own versions of a hand-held, portable ultrasound system. However, Choi still thinks that Butterfly's price would have to come down even further for physicians to widely adopt the technology.

“It's competitive in the hand-held ultrasound space, but the real takeoff is if you have a device that’s comparably priced to a stethoscope, which is about $175,” Choi said.