A new transducer could dramatically lower the cost of ultrasound scanners | Hacker News Reader

A new transducer could dramatically lower the cost of ultrasound scanners

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98 pointsjonjlee34 comments

We'll see if they ship!

The company that is really killing it in this space right now is https://www.butterflynetwork.com/

I worked at a startup making a handheld ultrasound machine back over a decade ago. Even back then we could easily power the transducer using a mobile phone capacity battery, you just need to step up the voltage to around 100v so you could feed it through the transducer and you'd get a signal back.

Last I heard the place is still going although most of the people I worked with have left already.

EDIT: Back then we were eyeing up using MEMS technology instead, though I don't think anything happened with that.

This would be great for animal husbandry. So much guesswork and tracking of schedules would be unnecessary if a veterinarian weren't required e.g. to determine follicle size. I will buy three or four, when they're $100.

I would too, for the same reason and for other “paravet” diagnostic work on my unit.

That said, in cattle I found (with a bit of vet coaching) it wasn’t hard to recognise follicles, distinguish from (and gauge size of) a corpus luteum, etc by manual palpation, at least for someone who AIs reasonably regularly anyway.

Our vets seem no less accurate this way than with their expensive heads-up toy! (I doubt I’m as accurate - I don’t get anything like the practice they do - but very handy for quick sanity check.)

you can get chinese vet grade USS machines for ~$500

Out of curiosity (and some docs I'm writing) :

Any brand or model you can tell me?

That's price bought in the US or sourced in China via AliExpress or similar?

Have you used these machines? When I have purchased dental equipment from these sources, results have been somewhat hit-or-miss.

Paired with deep learning it would be very helpful for early tumor screening at home. My girlfriend already had cancer twice, but the usual screening is done only once every 6 months.

Overscreening/overtreating is a problem. We all have tumors growing all the time, but our immune systems fight them off.

https://www.mdedge.com/fedprac/avaho/article/98510/oncology/...

For the extra keen, here is the Nature Microsystems & Nanoengineering paper about this work released Aug 27 2018:

https://www.nature.com/articles/s41378-018-0022-5

Disclosure: one of the co-inventors in the article was my graduate supervisor. I had no relation with this work however.

I hope this reaches hospitals and patients soon. I recently had to pay ~$1k for a transvaginal ultrasound at Stanford Hospital. That is what I paid AFTER insurance, I think the hospital billed the insurance company another $5k or so. Absolute highway robbery, and prohibitive for many people in need of these assessments.

I don't think the price of the equipment is very relevant. The same procedure (using a probe) costs €100 in a private hospital in my EU country.

In germany medial procedures are priced in a catalog with factors as wiggle room depending on the case, an ultrasound (GOÄ 410) is around 15€ and there is a trans-cavital added charge (GOÄ 403) of around 15€.

My wife did a full fetal ultrasound on a latest Samsung machine (they're awesome, btw), with consultation - total cost around 100 euros. Fully private w/o insurance. We could've gone via insurance, and then it would've been absolutely free (well, included with work insurance) but machine used with them doesn't offer as high resolution or have as many capabilities (volumetric reconstruction and other imaging wonders).

This is in Croatia, so what gives? Pay scale for doctors are around 4x as much at Stanford Hospital, and machines cost about the same, Croatia also has a higher tax, but bay area has higher costs. ~60x higher costs? I don't think so, nor do I remember it so. I don't remember Palo Alto having any better basic medical services than here in Croatia either. Was that the price for ultrasound alone? Sounds outrageous.

> A pelvic ultrasound typically is covered by health insurance when ordered by a doctor for diagnosis of a problem. For patients covered by health insurance, out-of-pocket costs typically consist of a copay of $10-$50 or more, or coinsurance of 10%-50% or more.

> For patients not covered by health insurance, the cost of a pelvic ultrasound typically varies by provider and geographic region. The typical cost range is $250-$1,100, with a national average cost of $525, according to NewChoiceHealth.com[1] . For example, Concierge Medicine[2] in California charges $275 for a pelvic ultrasound

https://health.costhelper.com/pelvic-ultrasounds.html

> ... Stanford Hospital ...

The times I’ve used them, the original bill was so outrageous I fumed for days.

Insurance paid ~$15K and they billed me for my entire OOP max for the year ($7,500) for a service that cost about $400 tops to provide.

Contested the bill and they do a medical review of the coding. They had billed as “intensive care” the administration of a single shot and a standard blood count.

They actually came back and claimed the coding was correct! Kept fighting it for about 6 months and they ended up dropping the entire thing at no cost. But they still got to keep the insurance payout.

Just another form of price gouging / variable pricing which should be illegal.

I was pointing out that grandparent didn't shop around. Convenience always has a cost.

And in US, it's always worth asking for the uninsured price too. When you don't use your insurance, the medical providers compete against themselves and you get market price. Of course, insurance tries very hard to prevent you from bypassing them.

Completely agree with you! At the same time, my personal experience is that Stanford Hosptal billing is outright fraudulent.

And they appear to know it, so don’t treat the bill as some final price, it’s actually just the first round offer to take advantage of people who don’t have the time or inclination to fight it.

It seems you are right. Must be one of those bay area perks :)

> Stanford Hospital and Clinics in Palo Alto and Sutter Medical Center in Sacramento are two of the most profitable U.S. hospitals, yet both hospitals carry the “nonprofit” designation, according to a new study.

> The most profitable hospitals had the highest patient care markup rate, the authors found.

https://sanfrancisco.cbslocal.com/2016/05/03/nonprofit-stanf...

Agreed. I would have shopped around if I knew this was going to be a major expense. My gyno referred me for this to follow up some questions after my annual exam and he was very nonchalant about it. I had never had an ultrasound, but I thought it seemed like a no-big-deal kind of thing on the level of a dental x-ray, especially since I have pretty good insurance, and that casualness was matched by the doctor's attitude. Nobody showed me a bill or price until I was waiting with a full bladder, ready to be scanned.

My wife had one of those “fun scans” when pregnant. That cost $150, lasted 45 minutes, and the machine (color 3D) was way more advanced than the diagnostic machine. The that was not a rip off.

Call it a medical procedure, and run it through a radiologist, and the cost shoots up 10x minimum. So where is all the money going?

The thing looks pretty fragile -- one of the reasons why they use piezo based systems is they are pretty robust.. I guess I am not clear how this system equates to getting a $100 ultrasound machine.. I'm gonna go out on a limb here and say this system probably is not going to replace normal ultrasound systems for some time.. but could be used to wrap one of these membranes around say your heart and have something like an implantable ultrasound heart monitor..

Sorry, can I have some explanation on how piezo-based ultrasound systems aren't considered fragile? Even within their casing, dropping or banging one risks damaging the crystals.

Using Philips Lumify, Clarius' C-3, and other transducers, I think we've seen a bit of what low cost ($1k - $10k range) ultrasound machines with the same form factor can do to the market. Rather than displace the whole market, low cost ultrasound created a new fragment and opened doors for more clinicians and more clinical applications. The higher end machines are still regularly used and sought after (you can't really get the image quality and amazing beamforming otherwise).

I do like the idea of implantable ultrasound heart monitor! Fun to think about.

Disclosure: one of the co-inventors in the article was my graduate supervisor. I had no relation with this work however.

One still needs expensive FPGA or DSP for beamforming in decent ultrasound machine. Nothing for 100$. Maybe some single channel sensor, but I also doubt that after FDA approval price will stay in 100$ range. Plus I am worried about long time stability of polymers. Moisture or UV or mechanical load can alter polymer’s structure.

Moore's law will take care of the processing cost nicely, especially as more commodity processors become powerful enough to handle it.

The ADCs and other analog stuff might be more of a hurdle, the design of them is quite hard, they aren't able to take advantages of smaller transistors as well, and competition in the space is decreasing as semiconductor companies keep merging (e.g. Analog Devices and Linear Technologies).

At these low frequencies very simple oversampling Delta-Sigma ADCs work well, considering the sample rate is in the low 3-digit MHz range at most, which can easily be processed by even an 15$ FPGA that has SerDes suitable for USB3 or PCIe2 [0]. Considering you can just shift the noise out of the frequency of your ultrasound with the correct averaging filter in the FPGA to convert the 1-bit high sample rate to many-bit passband (one might want to fold the quadrature demodulator for RX phase sensitivity into this filter to save on comnpute). It would basically be a many-channel, fixed frequency (by software configuration only) RX SDR.

[0]: https://www.mouser.de/ProductDetail/Lattice/LFE5UM5G-25F-8MG...

The clock jitter may get you. You can oversample and decimate to obtain the equivalent ENOB, but then the sample clock stability becomes more difficult and costly.

Beamforming is cheap, for sectorial scan phone cpu can easily handle it, of course it will not be all big HQ image, but for initial scan is enough, but ADC with pulse generator - that one is expensive, for decent quality digital steering you need for example minimum 16 channel adc in mhz range and that one is not cheap. If you think it cheap go and google 128 channel ADC plus 128 pulse generators with protection circuit (i know somebody says overkill, but for ndt is pretty norm)

ndt - non destructive testing

Googled it. DDC1128ZKLT ADC costs 212€ a piece, but can sample at 6.25 kS/s what is way too low for this application. 8 fast 16 channel ADCs cost a fortune. They also require at least one FPGA with high pin count and these aren’t cheap either. My conclusion: decent ultrasound scanner can’t be cheap from bill of materials perspective alone.

Great, now instead of simply googling my symptoms, I can also attempt to read an ultrasound. Image search maybe?

You can also use ultrasounds to see your body composition. As in how much of this body part is fat vs muscle.

Although I think 3d imaging will work in a more convenient manner for that purpose, and it will only get cheaper, so I doubt it will become that popular for that purpose if it was made cheap.

Ok, that is just awesome. There are a ton of uses for low cost ultrasound from trauma care to package inspection.

Package inspection? As in parcels? If so, how do they get an acoustic window?

X-ray/CT is much more useful for these.

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