Butterfly IQ+ Ultrasound

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.

Guillemot

Full Member
10+ Year Member
Joined
Dec 24, 2010
Messages
793
Reaction score
1,092
So I received an email from Butterfly stating that they had a new and improved model of their ultrasound device. Their website though doesn't actually have any details about how image quality compares to the first generation device. Anyone know anything about the IQ+ or have links to any reviews and comparisons to the original IQ?

Members don't see this ad.
 
Based on their website's lack of detail, I'm guessing the image quality is the same as the first generation device. If it were better, they'd probably want to show evidence of that on their site.

I have the original and use it a reasonable amount because my shop doesn't have many ultrasound units. I've definitely gotten my money's worth, but the IQ+ doesn't seem to be worth 2k to upgrade for those who have an original IQ. Looking forward to future generations when they have actual improvement in image quality.
 
Members don't see this ad :)
Based on their website's lack of detail, I'm guessing the image quality is the same as the first generation device. If it were better, they'd probably want to show evidence of that on their site.

I have the original and use it a reasonable amount because my shop doesn't have many ultrasound units. I've definitely gotten my money's worth, but the IQ+ doesn't seem to be worth 2k to upgrade for those who have an original IQ. Looking forward to future generations when they have actual improvement in image quality.

Is the image quality good enough for US guided IV/Aline/Supraclav/adductor canal/popliteal ?
 
Yes, it is good enough for what you mentioned. Though not as good as a good sonosite.
 
  • Like
Reactions: 1 users
Anyone have facility/biomed impediments to personal device use? i.e. procedural/facility fees for services using devices owned by the hospital...
 
  • Like
Reactions: 1 user
Is the image quality good enough for US guided IV/Aline/Supraclav/adductor canal/popliteal ?
Yes, it is good enough for what you mentioned. Though not as good as a good sonosite.

I suspect it is good enough, but how are you submitting evidence of ultrasound use to insurance? A picture needs to be in the chart somehow. Many of our private carriers deny the ultrasound modifier without it.

Honest question as I am not sure how the Butterfly interface works.

I also suspect my facility won’t be friendly about bringing in personal equipment for this sort of thing. Although the don’t tell attitude is probably valid. We also have an OK number of ultrasounds around.
 
Last edited:
  • Like
Reactions: 1 user
Members don't see this ad :)
I suspect it is good enough, but how are you submitting evidence of ultrasound use to insurance? A picture needs to be in the chart somehow. Many of our private carriers deny the ultrasound modifier without it.

Honest question as I am not sure how the Butterfly interface works.

I also suspect my facility won’t be friendly about bringing in personal equipment for this sort of thing. Although the don’t tell attitude is probably valid. We also have an OK number of ultrasounds around.

Good question. I’m not sure. I don’t include the picture in my charting of the block. Billers have said I don’t need to. I don’t know if that means they track the pics down or they just don’t bill. I have no clue. I used to ask my billers lots of questions, but I never really liked their answers, so I’ve given up hope. I know that’s not stellar but it is what it is I guess, for now.
 
Good question. I’m not sure. I don’t include the picture in my charting of the block. Billers have said I don’t need to. I don’t know if that means they track the pics down or they just don’t bill. I have no clue. I used to ask my billers lots of questions, but I never really liked their answers, so I’ve given up hope. I know that’s not stellar but it is what it is I guess, for now.


What I’ve been told is that the images aren’t sent immediately to the insurance companies and you’d only need to show the actual image if audited.
 
What I’ve been told is that the images aren’t sent immediately to the insurance companies and you’d only need to show the actual image if audited.

This is the correct answer. Epic has an option on the mobile app to take pictures and upload them to the media section.
 
What I’ve been told is that the images aren’t sent immediately to the insurance companies and you’d only need to show the actual image if audited.

Mostly true. For 2 of our insurers they mostly pay it out, but a couple times a month at random they will ask for proof. If you provide it (say via Epic media) great they move on, if you can’t (say the image wasn’t uploaded correctly) then they deny you and start asking more frequently. Not truly an audit, just asking for proper documentation to see if they can get away with paying you less.
 
  • Like
Reactions: 1 user
I suspect it is good enough, but how are you submitting evidence of ultrasound use to insurance? A picture needs to be in the chart somehow. Many of our private carriers deny the ultrasound modifier without it.

Honest question as I am not sure how the Butterfly interface works.

I also suspect my facility won’t be friendly about bringing in personal equipment for this sort of thing. Although the don’t tell attitude is probably valid. We also have an OK number of ultrasounds around.

Roundabout way to get butterfly image into patient’s chart.

1. Screenshot image on your iPhone in butterfly app.

2. Email screenshot to self.

3. Open email on epic/tangent monitor.

4. Haiku photo of image displayed on epic/tangent monitor.
 
  • Like
Reactions: 1 users
I ordered the IQ+ when it came out and got it a few days ago.

They do advertise slightly better image quality and framerates compared to the original IQ, but for me the biggest selling point was the user-replaceable cable. Not only can you replace it if it gets damaged, but you can also switch between lightning and USB-C on the same probe simply by swapping the cable. The original IQ could do neither of those things.

Image quality seems pretty good for vascular access and even for some nerve blocks. TTE quality seems decent, but not as good as a dedicated phased-array probe.

Here's a supraclav and IJ with the IQ+, just for reference:
 

Attachments

  • screenshot.1603039462.png
    screenshot.1603039462.png
    216.9 KB · Views: 147
  • screenshot.1603039505.png
    screenshot.1603039505.png
    260.1 KB · Views: 150
  • Like
Reactions: 7 users
I ordered the IQ+ when it came out and got it a few days ago.

They do advertise slightly better image quality and framerates compared to the original IQ, but for me the biggest selling point was the user-replaceable cable. Not only can you replace it if it gets damaged, but you can also switch between lightning and USB-C on the same probe simply by swapping the cable. The original IQ could do neither of those things.

Image quality seems pretty good for vascular access and even for some nerve blocks. TTE quality seems decent, but not as good as a dedicated phased-array probe.

Here's a supraclav and IJ with the IQ+, just for reference:
Thanks for the pictures. Guess that is why we use the nice ones, but that seems adequate for simple things.
Reminds me how far U/S has come.
 
I ordered the IQ+ when it came out and got it a few days ago.

They do advertise slightly better image quality and framerates compared to the original IQ, but for me the biggest selling point was the user-replaceable cable. Not only can you replace it if it gets damaged, but you can also switch between lightning and USB-C on the same probe simply by swapping the cable. The original IQ could do neither of those things.

Image quality seems pretty good for vascular access and even for some nerve blocks. TTE quality seems decent, but not as good as a dedicated phased-array probe.

Here's a supraclav and IJ with the IQ+, just for reference:

Could you post a picture with the needle out of plane and in plane? i'm thinking about buying one but every institution i work at has enough ultrasound so far.
 
Could you post a picture with the needle out of plane and in plane? i'm thinking about buying one but every institution i work at has enough ultrasound so far.

If you have enough ultrasounds at work, I wouldn’t recommend buying one. It just becomes an expensive, albeit cool, toy.
 
  • Like
Reactions: 2 users
If you have enough ultrasounds at work, I wouldn’t recommend buying one. It just becomes an expensive, albeit cool, toy.

Fair. Still want to see the picture quality with needle.
 
  • Like
Reactions: 1 user
Does the picture quality matter if you have a rough idea and use a little local or saline to identify spread?
 
Could you post a picture with the needle out of plane and in plane? i'm thinking about buying one but every institution i work at has enough ultrasound so far.


Yep, I should be able to get this next week.
 
  • Like
Reactions: 1 user
I've been looking into ordering one. I'm a urologist, would mostly be looking for basic abdominal ultrasound work (Bladder scans, measuring prostate volume, looking at kidneys to ensure no hydronephrosis/confirm stone passage). Anyone used the abdominal settings enough to feel good about that?
 
Could you post a picture with the needle out of plane and in plane? i'm thinking about buying one but every institution i work at has enough ultrasound so far.

PIV placement in a BMI ~65 patient today.
 

Attachments

  • screenshot.105.jpg
    screenshot.105.jpg
    120.5 KB · Views: 185
  • screenshot.106.jpg
    screenshot.106.jpg
    126.1 KB · Views: 185
  • Like
Reactions: 9 users
0.5cm of fat and BMI 65 :unsure: doesn't add up. Nice picture nonetheless

Luckily...the patient was pear-shaped and didn't have a ton of fat on the forearms. The actual BMI was 67.
 
  • Like
Reactions: 1 user
Just received mine. Liking it so far. Image quality is improved from the original.
For the price , worth it. I won’t be renewing the yearly subscription unless covered by CME money.
 
  • Like
Reactions: 1 user
Image quality is still pretty decent with deeper vessels. This was a basilic IV placement on an obese patient.

1605754441618.png
 
  • Like
Reactions: 2 users
I did cursory TTEs on a few people with the old butterfly when I got my hands on one. It seemed like due to the transducer shape/size it might be awkward to use for vascular access, but the pictures here are more impressive than I thought. Do you have to adapt your PIV/a-line technique at all vs a normal ultrasound?
 
  • Like
Reactions: 1 user
These images are on par with the 15 year old battered to hell sonosite I am stuck with at one of my hospitals. Seems great as a field/clinic technology tool or where there are limited resources but definitely no replacement for a legit ultrasound.
 
  • Like
Reactions: 1 user
I did cursory TTEs on a few people with the old butterfly when I got my hands on one. It seemed like due to the transducer shape/size it might be awkward to use for vascular access, but the pictures here are more impressive than I thought. Do you have to adapt your PIV/a-line technique at all vs a normal ultrasound?

Yes, the Butterfly probe is thicker than a normal linear probe, so I generally choose a skin stick location closer to the probe and not as far behind the probe as I would with a Sonosite. On short axis, out of plane views, the needle tip won't be visible until it is under the middle of the relatively thick probe.

Where are you placing your phone when using this for procedures?
Pretty much wherever is convenient. I know some people have gotten phone mounts that can clip to an IV pole, so that's another option.

These images are on par with the 15 year old battered to hell sonosite I am stuck with at one of my hospitals. Seems great as a field/clinic technology tool or where there are limited resources but definitely no replacement for a legit ultrasound.

I don't disagree. Image quality is probably in the same ballpark as Sonosite M-Turbo, but good enough to be usable for vascular access and quick POCUS evaluations. Newer ultrasounds like the Sonosite XPorte are obviously going to have better image quality, but they also cost $80k and don't fit into a pocket. As the saying goes, "the best camera is the one you have with you."
 
Last edited:
  • Like
Reactions: 1 user
Hello everybody I'm new, i need help with my Butterfly iq, i'm the second owner, i don't have the user name or password, i think i have yo buy a membership but i don't know how, may I Buy just the basic one? Which features i'm gonna lose?
 
Top