March 8, 2020

Tech Update: Artificial Intelligence

“Some people call this artificial intelligence, but the reality is this technology will enhance us. So instead of artificial intelligence, I think we'll augment our intelligence.” —Ginni Rometty

Major trends in ultrasound technology that have seriously influenced and changed the terrain of medicine include the improvement of ultrasound workflow through the reduction of processing times, the reduction in number of keystrokes, the automation of measurements, and the advances in ultrasound visualization with 3D technology and reconstruction. However, the most promising and indeed the most interesting trend is the development and integration of artificial intelligence in ultrasound and its partnership with the fast moving world of social media and global communication. This partnership is now connecting academics to physician sonographers in remote areas, providing a chance to enhance, improve, and exchange their techniques, skills, and knowledge.

Probably the most well-known and publicized Artificial Intelligence (AI) technology involves the Butterfly IQ. This new portable ultrasound probe attaches to your friendly neighborhood iPad/iPhone with the all-in-one surface that can scan vascular, abdominal, and chest structures through the integration of Capacitive Micromachined Ultrasonic Transducer (CMUT) technology found in computer chips. With the recent launch of this system, Butterfly IQ is utilizing its users’ data to develop and perfect its AI. Its goal is to teach an inexperienced sonographer better scanning technique by analyzing the user’s movements, then directing the user on how to generate better images.

University of British Columbia engineers have produced a probe the size of a band aid that produces images that apparently are as sharp as traditional ultrasound machines. These probes, similar to Butterfly IQ, utilize CMUT technology. They are made from polymer resin rather than silicone called polyCMUTs (polymer capacitive micro-machined ultrasound transducers) and are cheaper to manufacture because they use less equipment to be made. They only need 10 volts to operate and this can be powered by a smart phone similar to Butterfly IQ or Philips Lumify. The transducer has the potential to be built into flexible material due to its small size so that it can be wrapped around the body for more detailed scanning. The potential for these miniature transducers include scanning vasculature and tracking your heart internally and the University of British Columbia is in the process of making prototypes to test these possibilities out.

The other way in which AI is integrated is quite subtle - through the improvement of work flow. One example is the 3D flow valve analysis in the Siemens eSie machine created to assess heart valves. Also, Philip’s Epiq AI technology automatically identifies and color codes anatomical structures in order to select the best view to enhance reproducibility. Further, GE Vscan’s DiA Imaging Analysis has automated calculation of ejection fraction (EF). Lastly, Konica Minolta’s Sonimage HS1 uses AI-voice recognition controls for hands-free operation in musculoskeletal interventional procedures allowing the provider to control system functions without the need of an assistant.

Companies such as Philips, GE, and Butterfly IQ are now connecting physicians around the world with experts in ultrasound through the integration of cloud technology, AI, and social media. Butterfly IQ users can now upload their images to a HIPAA compliant cloud server, and both Philips Lumify and Butterfly IQ users can communicate live to another physician or expert sonographer to get real time advice on what they are seeing and scanning from someone thousands of miles away. These capabilities have changed the terrain of medicine for providers in places like Rwanda where Philips Lumify paired with non profit organization PURE help physicians in remote places have access to the type of expertise they need.

It will be fascinating to see what the next few years will bring as AI helps to enhance our knowledge of the human body, while bringing us together far and wide through the ever advancing terrain of social media and cloud networking.

The authors have no conflicts of interest to disclose.


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Natwalee Kittisarapong, DO
Kaiser Permanente

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