Comparing an Inexpensive Handheld Ultrasound Machine and a Large Mobile Ultrasound System
Condition: Ultrasonography
Study type: Observational

Summary: 
      To assess the quality of images and diagnostic ability of a handheld device under two
      thousand dollars against those of a bigger and more expensive ultrasound machine.
    

Detailed description: 
      Ultrasound technology is frequently used to obtain information, usually at patients bedside.
      The images obtained are used to guide procedure (i.e central line placement, epidural needle
      guidance) or to make diagnosis (i.e abnormal placentation, presence of pneumothorax). Given
      that the majority of this procedures and diagnosis are made at bedside, the ideal ultrasound
      machine should be portable, lightweight, and within an acceptable price range. Our current
      ultrasound machine (Sonosite - M turbo) has a price range from 15,000-20,000 dollars, not
      including the different probes that are needed to obtain images at different depths in the
      human body. Much of the cost is due to the ultrasound transducers, which have been
      traditionally based on piezoelectric technology. Such probes work by passing current through
      a piezoelectric crystal (typically quartz) that then vibrates rapidly and generates an
      ultrasound pulse. Creating crystal arrays is difficult and often requires hand-manufacturing.
      Furthermore, this technology is analog and requires downstream analog-to-digital processing
      hardware. Together, these characteristics increase device costs and restrict the broader
      dissemination of ultrasound technology.

      Recently, the Butterfly iQ company created an ultrasound that is portable and at a price of
      slightly under two thousand dollars it allows the physician to obtain images for diagnostic
      and/or procedural guidance using a single probe. The company was able to significantly
      reduced the cost and the need for additional probes by utilizing Capacitive micro-machined
      ultrasound transducers (CMUTs). Essentially instead of relying on the use of specific
      piezoelectric crystals (current ultrasound technology), they are using a micro-chip
      technology to emit the vibrations that would be used to form an image. Butterfly Network has
      developed a CMUT imaging device that has been designed to be compliant with all applicable
      FDA safety regulations (see section II.C), while enabling increased portability and real-time
      smartphone-based image review due to the integrated circuit design. The Butterfly device was
      FDA-approved as of October 2017. The proposed study will compare the images acquired by the
      Butterfly iQ and our current Sonosite M-turbo US.
    

Intervention name(s): Large Mobile Ultrasound System; Handheld Ultrasound Machine
Intervention type(s): Device; Device
Intervention description(s): 30 spine images, 15 Transverse abdominis muscle and 30 Obstetric images (i.e placenta, uterine blood flow, etc) images will be obtained using the large mobile ultrasound system.; 30 spine images, 15 Transverse abdominis muscle and 30 Obstetric images (i.e placenta, uterine blood flow, etc) images will be obtained using the handheld device.
Other intervention name(s): Sonosite - M turbo; Butterfly iQ device
Observational model: Cohort
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Patients between the ages of 18 and 45 presenting for cesarean delivery requesting a
        transverse abdominis block, epidural, or in need of an obstetric US.