Rarely is black and white diagnostic medical imaging given the breathtaking design and marketing treatment, but when it is, you get the Butterfly iQ. Undeniably attractive, its branding even makes me want to buy one – but as it seems to promise the world at impossibly low pricing, I thought I’d better investigate a little further.
Not as cheap as it looks
The first point is that it’s not actually as cheap as it seems. £1700 or $2000 seems amazing, but when you add in the £360 or $420 annual subscription charge, the “starting at £1699” or “starting at $1999” is misleading. You cannot buy it without a user license for the software, so it’s not starting at £1699. It’s starting at £2059 (or $2449 if you’re in the USA). Then it’s another £95 for the case, and – oh, did we not mention pricing was excluding tax? – that’ll be another £430 at checkout. So, starting at £2584 (or over $3000).
Don’t get me wrong, this is still an excellent price. I just really dislike disingenuous marketing. It instantly breaks my trust and makes me wonder what else they’re not quite being straight with me about, and when we’re talking about an ultrasound machine, that’s hugely problematic because we buy off the basis of the demo images we are shown: trust is essential.
The all-in-one ultrasound transducer
This claim should come with a disclaimer. This ultrasound machine is a fantastic point-of-care solution, ideal for generalists (emergency physicians, A&E doctors, etc.). It is not ideally suited for small animal scanning (dogs, cats, goats), has no microconvex option, and currently lacks a complete veterinary measurement package. The real selling point for me as a solution for veterinarians is the telemedicine aspect. Using horses as an example as their website seems to focus heavily on this: no equine vet I know would even consider this type of ultrasound machine for tendon scanning. They require exceptionally high resolution linear imaging. However, the idea that a trainee could go out on farm and acquire images with the remote guidance or feedback of an experienced colleague back at the practice is hugely attractive.
The problem with this machine for individual users, however, is that they do not have ready access to such experts. What they will end up receiving for their £2500 or $3000 will in fact be a very expensive ultrasound transducer that is suboptimal for their use, the main selling points of which are of no benefit to them whatsoever. For dog breeders, cat breeders or goat farmers, I’d recommend a device specialised to their specific needs. With the ScanX portable ultrasound machine, training can be delivered remotely by professionals who do what you do, such as scanning animals for pregnancy.
All-day scanning
I found this claim really odd, particularly as it was followed by “it lasts the shift, and then some. Designed with both a built-in battery and wireless charging, the Butterfly iQ offers over two hours of scanning.” Perhaps I’m in the minority here, but two hours of scanning does not strike me as particularly impressive, and certainly not my definition of “all-day scanning.” This isn’t clearly mentioned on their website, but after some digging, it also appears that recharge time is five hours.
At 320g, the transducer also weighs around 3x that of a standard ultrasound transducer. While this may still seem light, manipulating 320g with your wrist for extended periods is not for everyone, particularly if you suffer from arthritis.
Cool down
Another issue that isn’t mentioned on their website (at least, nowhere I could find) is that this transducer can only scan for around twenty minutes before requiring a cool down period.
Again, possibly perfectly adequate for point-of-care, but definitely not suitable for farmers who would be scanning one animal straight after the other. Holding onto an impatient animal out on farm while you wait for your machine to allow you to resume scanning is definitely no fun.
Conclusion
The Butterfly iQ is a fantastic-looking machine that successfully commercialises all of the best research and ideas in diagnostic ultrasound right now. I’d love to get my hands on one for point-of-care hospital use, but wouldn’t want to be bringing one of these on farm, for canine pregnancy scanning, or even for scanning within the veterinary clinic.
The problem with such a great looking device and uncontrolled distribution (anyone can buy one off their website) is that people who know nothing about ultrasound – which is most of us when we first start getting involved in something new – will be persuaded by its sheer beauty and flashy marketing into thinking that it is going to work for them. Unfortunately, finding the right ultrasound machine and becoming proficient in its use is a lot more involved. Abandonment is a huge problem in the world of animal scanning, and the only way that people will stick with the technology is with the guidance and support of experts.
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