Comparison of 6 handheld ultrasound devices by point-of-care ultrasound experts: a cross-sectional study.

Background: Point-of-care ultrasound (POCUS) has emerged as an essential bedside tool for clinicians, but lack of access to ultrasound equipment has been a top barrier to POCUS use. Recently, several handheld ultrasound devices ("handhelds") have become available, and clinicians are seeking data to guide purchasing decisions. Few comparative studies of different handhelds have been done. We conducted a cross-sectional study comparing 6 handhelds readily available in the United States (Butterfly iQ + ^™ by Butterfly Network Inc.; Clarius^™ by Clarius Mobile Health; Kosmos^™ by EchoNous; TE Air^™ by Mindray; Vscan Air^™ SL and CL by General Electric; and Lumify^™ by Philips Healthcare). A multi-specialty group of physician POCUS experts (n = 35) acquired three standard ultrasound views (abdominal right upper quadrant, cardiac apical 4-chamber, and superficial neck and lung views) in random order on the same standardized patients and rated the image quality. Afterward, a final survey of the overall ease of use, image quality, and satisfaction of each handheld was completed.

Results: Thirty-five POCUS experts specializing in internal medicine/hospital medicine, critical care, emergency medicine, and nephrology acquired and rated right upper quadrant, apical 4-chamber, and superficial neck and lung views with 6 different handhelds. For image quality, the highest-rated handhelds were Vscan Air^™ for the right upper quadrant view, Mindray TE Air^™ for the cardiac apical 4-chamber view, and Lumify^™ for superficial views of the neck and lung. Overall satisfaction with image quality was highest with Vscan Air^™, Lumify^™, and Mindray, while overall satisfaction with ease of use was highest with Vscan Air^™. The 5 most desirable characteristics of handhelds were image quality, ease of use, portability, probe size, and battery life. Ultimately, all 6 handhelds had notable advantages and disadvantages, with no single device having all desired qualities or features.

Conclusions: The overall satisfaction with image quality was rated highest with Vscan Air^™, Lumify^™, and Mindray TE Air^™when acquiring right upper quadrant, apical 4-chamber, and superficial neck and lung views. No single handheld was perceived to be superior in image quality for all views. Vscan Air^™ was rated highest for overall ease of use and was the most preferred handheld for purchase by POCUS experts.