Slashdot Mirror
Imaging Breakthrough "Sees" Lung Disease
Roland Piquepaille writes "According to BusinessWeek, an Israeli startup, aptly named Deep Breeze, has developed a high-tech replacement for the 200-year-old stethoscope. This noninvasive device can draw, in seconds, an image of your lungs by listening to its vibrations. The Vibration Response Imaging (VRI) system could already be used in Israel, Europe and South Korea. Last month, the US Food and Drug Administration approved its introduction in the US. But don't expect to see one of these systems used by your local physician anytime soon. This VRI system will carry a price tag of over $40K."
Your gunna need some good insurance for that thing to ever save your life.
America is cold blooded.
But is $40K a lot as far as medical devices cost? How much is the x-ray machine at the doctor's office, or the ultrasound equipment at the heart specialist?
Computers are useless. They can only give you answers.
-- Pablo Picasso
You're worth every penny.
That really no where near the price of a MRI machine so I'm pretty sure that it is as capable as the article makes it sound than thats not that much to spend. Several hospitals in my area have spent 100+ million in renovations.
At $40,000 it may not be around every doctor's neck, but geez just the exam table I sit on and the scale they make me stand on totals a staggering amount. I can't imagine something in the tens of thousands being cost prohibative to the medical field.
The real question is how often will this be used? Not every doctor is going to need this as, it seems, this is going to start out as a specialist item. Your local hospital may only have need for one of these things in the long run.
In any case this is a good step forward and I'm glad to hear about it...
Now, where did I put that pack of Camels???
Dedicated Cthulhu Cultist since 4523 BC.
I can tell you that radiology/cardiology and a lot of the imaging modalities is really where hospitals make a lot of their bucks. I'm actually a medical consultant. While I don't work with the machines much at all, I work with getting properly trained staff out at the places. I get the impression that a lot of the machines are in the quarter to half million dollar range. I can tell you that an ultrasound technologist can make quite a few pretty pennies :) The good ones can get into the 6 figures easily annually. Hospitals rely on them so much that when they're short handed, they're willing to pay $50 to $100 dollars per hour for long extended periods (3-12 months at a time) to make sure they have someone running their machines.
Any specialist will have that machine in the next few years. $40k is pocket change. My optometrist in a small town has imaging equipment that cost at least that much years ago.
A state-of-the-art MRI or CT scanner cost upwards of $5 million. $40,000? Easily within the reach of even your local general practitioner.
But using sound to create an image? This is exactly what an ultrasound does.
Why, when there is an article about something visual, especially a revolutionary new visualization system, do they never show pictures.
I hate that.
If you are reporting on a neat visual thingy,... SHOW ME THE THINGY. Even a picture of the machine would be a plus, even if it looks exactly like an MRI or some other machine. I don't care if the picture may mean nothing to me. Put a little caption trying to explain it. It doesn't matter, show me SOMETHING.
Does anyone have a picture?
This should be criminal.
(the annoyed MBCook)
Comment forecast: Bits of genius surrounded by a sea of mediocrity.
So we have Businessweek's perspective on things, where--in the very first few sentences--the word "sales" sparkles out. Anyone have a little more to add about the technical side of this imaging system?
When MRI and other can cost over $1 million, 40k isn't that much.
Really, using sound for imagery is no news. Marketing it under a different name may be...
The technology "measures energy generated in the lungs"? Ultrasound works by transmitting an acoustic pulse into the body and processing the reflected sound. These frequencies are up to the MHz range, and are used because they have a small wavelength. Smaller wavelength means better imaging resolution. I highly doubt our lungs are generating the MHz frequencies necessary for this to occur. /out
When reached for a follow up comment on the price estimates, the representative from Deep Breeze said that the price was more likely closer to ONE MEEEEELION DOLLARS!
The representative also mentioned that it would include ill-tempered lab techs with laser beams strapped to their frikkin heads.
a Beowulf cluster of these... ...what? It already is a Beowulf cluster?
My work is done here.
"I think an etch-a-sketch with an ethernet port would beat IE7 in web standards compliance."
As (and if) this device becomes more widespread, the price will drop substantially. Or at least it should.
$40k for medical equiptment isn't bad. Compare it to the cost of a MRI machine, or even a 'low cost' (which is $100k-$200k) x-ray machine. Radiosurgery machines (for cancer) run $3-5 million. Having an accurate diagnosis for $40k is almost cheap by those standards.
What money? You mean the money you'll never see because the insurance companies will pocket it? Don't delude yourself, the decision to exclude health risks has absolutely nothing to do with saving you money, with saving doctors money or improving healthcare. It's about increasing the bottom line for insurance companies by charging higher premiums for things they can get away with. What's next? Charge extra if you have stairs in your house? Charge extra if you are black? Charge extra if you leave your house?
But is $40K a lot as far as medical devices cost? How much is the x-ray machine at the doctor's office, or the ultrasound equipment at the heart specialist?
Those machines go from $50,000 (xray) to $3,000,000 (CT, Linac, MRI). QC, operators and electricity are also expensive.
That makes this device sound cheap, but it could be way overpriced if it's nothing more than a microphone hooked to a stethoscope run through some FFTs. In that case, you are paying for a database of frequency signatures. Even if it's doing some kind of sonic imaging, the techniques are well known and you are paying for a specific implementation that will soon be duplicated. Other things you might be paying for are insurance and other parasitic paperwork. Hats off to the Doctor, but I'd like more details on how the thing works.
Friends don't help friends install M$ junk.
Massachusetts (my home state) has recently (a few months ago) passed legislation that requires all legal, full time employed residents to have health insurance.
FTFA:
"Deep Breeze aims to expand into the wider market. The company already is at work on versions of its device that could cost as little as $10,000. "It's so easy to use that we're looking to develop much cheaper models that will go into general practitioners' offices," says Avraham Ludomirski, managing partner at SCP Vitalife Partners, a U.S.-Israeli venture capital fund that is among the major investors in Deep Breeze."
which makes me wonder: would an independant practitioner (think doctor's office in an office building, not a giant medical associates building) consider purchasing one of these? obv i didn't thoroughly read tfa, but i can pick up a stethascope at my local Walgreens for $5. What is the driving force behind smaller practices looking into acquiring one of these, aside from diagnosing 1/1000000 non-smoker patients?
oh marmalade.
NT
Unless the technology is cheaper it is not a breakthrough. Slashdot has tagged this technology as breakthrough, hospital will say this technology as breakthrough, hospital bills will finally break through the pockets of the patient. Stethoscope comes under a price tag of 10$ and this machine carry a price tag of 40k fucking dollars. I never knew that I'll be explaining in 2007 that 10$ 40k$
This is nice in theory, however I don't see it really catching on.
For one thing, a stethescope is very cheap. Forty-thousand isn't a lot for a hospital, but if it's not necessary, they won't buy it. That money is better spent on salaries, or saving up for that high-tech imagine unit. Furthermore, even with an output from this, it's highly likely they'll order a CT or MRI anyway for a higher resolution picture.
I think that was an editorial remark from someone who doesn't know how much stuff costs. MRI machines cost MILLIONS of dollars.
I think the idea is that this device is supposed to be CHEAPER than MRI or CT scanning.
Give a man a fish and you have fed him for today. Teach a man to fish, and he'll say "WHERE'S MY FISH, YOU IDIOT?"
There would be even more money available if they dropped those without the ability to detect sarcasm...
They bleed me so bad now that I wouldn't even feel the prick.
"God fights on the side with the best artillery." - Napoleon, Marshal of France - speaking truth to power
In the dental imaging practice, the large pano devices (that scan around your entire head) go for $100k, while small sensors (of which a single office would have more than one) cost about $10,000 and regularly need replaced. This is a decent price.
A significant number of xrays and blood tests are run "just to make sure", not because a problem is expected.
If one of these lung viewers was available you can be sure it would get used to check out coughs and all sorts of complaints "just to make sure" and would find its way into medical examinations too.
Engineering is the art of compromise.
Here's a link to the abstract on pubmed. Looks like it's a bit early to say how useful it'll be.
d &Cmd=ShowDetailView&TermToSearch=17551264&ordinalp os=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_Res ultsPanel.Pubmed_RVDocSum
Dynamic Visualization of Lung Sounds with a Vibration Response Device: A Case Series.
Dellinger RP, Parrillo JE, Kushnir A, Rossi M, Kushnir I.
http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubme
Can someone please tell me how a machine is considered a "Food" or "Drug"?
Solomon
"Twice half-assed makes an ass whole." --Solomon K. Chang
Comany website:
i xp_system_from_deep_breeze.htmlm onary_imaging_modality_approved_by_the_fda.htmlh aft_archiv1/0000001_digitales_stethoskop.html
http://www.deepbreeze.com/
Multimedia:
http://medgadget.com/archives/2007/07/video_of_vr
http://www.medgadget.com/archives/2007/07/new_pul
http://www.thieme.de/viamedici/aktuelles/wissensc
Actual term is "substantially equivalent" when compared to a medical device that has been previously cleared for market. In this case there are two predicate devices, the Meditron Stethoscope System and the STG Monitor Multichannel Lung Sound Analysis System. FDA's 510(k)summary page is here - http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/ cfPMN/pmn.cfm?ID=21693
PDF of the summary is here -
http://www.fda.gov/cdrh/pdf6/K061495.pdf
There seem to have been a rash of health-related stories lately...
i ste.html.
:p Man, some slahsdot posts can be pretty poor.
I'm a doc, but from the article I have no good idea what this thing does. Sound waves to reconstruct pictures... well, this is called an ultrasound, as somebody already pointed out. Air is a really terrible conductor of ultrasound waves, so usually you'd get a black picture if you just used a u/s probe (that's why they use that goop to do ultrasounds on pregnant women.) True, with a pneumonia, you'd get a denser view, but a regular stethoscope will also tell you that.
Ok, maybe it takes the sounds it hears, and displays a histogram of intensity versus time. Well, this is called a phonocardiogram (phonogram), done for years, and HP and others even has a stethoscope that can do that. http://medgadget.com/archives/2005/05/androscope_
Ok, so maybe it does something more advanced, like using an array of sensors with high temporal (time) resolution with varying assumptions about sound velocity to try to interpolate a sound map of the lungs in space. Thus, low frequency sounds that come from a localized are of the lung could be assigned a color, high frequencies a different color, with the intensity of the color relating to the intensity of the sound... possible.
The things is, this sounds like somebody written by a businessman (not surprising, given the journal) and not somebody with medical knowledge.
From TFA: "Doctors often disagree about what they hear..."
Yes, but what you really care about is disagreeing about the diagnosis. It's rare, given all the tools currently available (CT scan, chest xray, good ol' fashioned stethoscope, what the patient tells you). I'm just not sure how this tool would help.
From TFA: "Kushnir has long criticized overuse of radiation among doctors."
Ooohh, hold on there... A chest x-ray is about equivalent radiation to 3 days on the beach, or a couple-hour flight (due to cosmic rays.) You don't see airline stewardesses with a lot of cancer. A CAT scan is considerably more radiation, though.
I'd like to sit down to a presentation / demonstration of the technology, but I doubt that this guy would get time in our hospital, as they seem more focused on taking the company public and making big bucks. I like to read about new technology in reputable medical journals, not Businessweek.
P.S. Last time I wrote to defend HP, people called me a corporate shill. This will show them!
Slashdotter, ID #101. UIDs are in binary, right?
"...know if I have lung cancer..."
TFA didn't mention cancer, either as something that counld be detected or as something that could not. Anybody know???
Or charge extra to afford the state of the art new facility in Santa Clara. Kaiser just opened a new facility in Santa Clara that is twice the size of it's replacement, 95% of rooms are private, and every room has a flat screen T.V. and a DVD player. I am not that against private rooms for those that are really sick or in need, but anyone who has seen new Kaiser facilities knows that they are marble palaces. All this and my premiums went up this year, after being raised last year. Disgusted......
All points of time and space are connected.
and a small operation? Price is relative to benefit.
I know you feel clever and all, coming up with new posts every day, but you really aren't helping your cause by annoying people.
IIAMS (Medical Student), and here how I see this device being used, docs will continue using regular stethoscopes because most diagnoses quite straightforward. When there are unusual sounds that require additional insight, then you break out the one VRI that is available in the physician's group. It would be similar to how most cardiac auscultation is straightforward, but when there is something particularly unusual, you send a person for an echo cardiogram. Even there where there is a well established, safe, accurate, non-invasive, relatively cheap imaging modality, you still listen first. Also, imaging isn't infallible, and just like different physicians can disagree about lung sounds, different radiologists can disagree about image interpretation.
TFA says that the price of the imaging modality will drop in the next few years with economies of scale and so forth. This is good, very good. It means that it'll make its way into the GP's practice soon and not just be in the hands of respiratory physicians and hospitals. But, honestly, look at things like this: TFA mentions that as far as replacing the stethoscope goes, it removes any sort of interpersonal bias between doctors in diagnosis. While this is just wonderful in respect to some esoteric diagnoses ie. whether you can *hear* a tiny small-cell carcinoma, but for the rest of us, I feel that a stethoscope, a quiet room and a competent doctor will suffice. The sounds of pneumonia, emphysema, pulmonary oedema, tuberculosis, bronchiole asthma etc. are all quite distinctive and as a medical student, I find it somewhat surprising that there can be any significant argument or doubt regarding the diagnosis of such patients. Heck, even if there was doubt, there are other elements of the presenting complaint (risk factors, family history, blood tests and plain old signs & symptoms) that can help doctors reach a definitive diagnosis. What I'm trying to say is, the old stuff works, its tried and true, and it's not easy to honestly miss pulmonary lesions. So, apart from being a novel visual toy (I know it's an instrument but how much fun is this?!) would it HONESTLY replace a $70 stethoscope and a head full of juicy knowledge brains? Me thinks nah :-p
Note that imaging with sound generated in the lungs naturally is apparently not possible because the source and frequency of the sound cannot be known in advance. The use of the word "Imaging" is apparently fraud.
The BusinessWeek article says, amazingly, begging the question, "Its sales prospects are not just hot air"
Notice that, at present, there is no period at the end of that sentence, suggesting that the article received little or no attention from an editor.
Slashdot has run several stories about companies that had products that they were supposedly trying to bring to market, but which, on close examination, apparently were just methods of collecting investor money, with no real hope of return.
Roland Piquepaille, the author of the Slashdot story, is apparently paid to get articles in publications an on blogs. There has never been any information, that I know of, about whether he pays someone at Slashdot or Slashdot's parent company. His Slashdot stories apparently never note Mr. Piquepaille's affiliations with the companies being discussed.
Slashdot has often been scientifically challenged. The Slashdot article The Car That Makes Its Own Fuel has a +5 moderated First Post that expresses the consensus of the comments on that story.
Where did all the accountants come from? Why is everyone talking about the price? We should be discussing the technology, how it works, how we can improve it, how it is based on an old idea, etc. All this talk about the price means nothing to us. We are the ones that should be building one of these on a weekend from scrap material.
Ok, more on the technique of VRI (Vibration Response Imaging)
l ogy/article-11.html
Here is the best description I could find that is freely available (not in a protected journal.) http://www.ctsnet.org/sections/thoracic/newtechno
The system basically has an array of sensors that sit over the patient's back, as they breathe in and out. It then displays an image from the sensors with a grey scale corresponding to the intensity of a given bin of frequencies observed by that sensor (and interpolated from nearby sensors, I presume.) You then get an image versus time of the frequencies in the lung, kind of like listening with your stethoscope in a bunch of different areas at once over many periods of time. It doesn't do any 3d imaging or interpolation.
A few studies exist validating the technique -- great that research like this is going on, but I don't think that I'd personally invest my healthcare dollars in this quite yet!
Slashdotter, ID #101. UIDs are in binary, right?
Can we please stop posting this asshat's submissions already?
...Daredevil, machine without peer.
So the thingy seems to have an array of microphones that sure look like stethoscope heads. They are replacing one stethoscope plus a trained physician's brain (making a mental image out of various sounds in various places) by many mikes and a computer to show the image. A good evolutionary change there, I'd say.
Yesterday was the time to do it right. Are we having a REVOLUTION yet?
Yes...and then?
I agree, it won't replace the stethoscope, but there is only so much a stethoscope can do. This is another tool to add to the set, and it appears to be a very interesting and useful one at that. Think of all the other ways to get an image of the lungs...none are even remotely as cheap as this.
So no, it won't replace the stethoscope...but the stethoscope also won't stand in the way of this being adopted. Rather, I expect they will become complimentary tools.
No Comment.
Now, if they could just come up with versions that can look at the prostate and the appendix, that would make a lot of people happy. For the younger ones who don't understand why I'm saying this, wait until you're 40...
The system cannot do imaging, which is what I said. That is partly because of reflections of sound from differing materials like air, flesh, and bone. It is not possible to know whether a sound that has been received directly, or as a result of a reflection.
Also, the wavelengths of the sound are far, far to long to allow discrimination of small details.
You said, "Slashdot might be occasionally scientifically challenged, but you are definitely demonstrating how scientifically challenged YOU are."
It's weird how people who comment on Slashdot assume that their guesses could not possibly be wrong, and another person's thoughtful comment that differs from their guesses indicates that the other person is ignorant.
I thought that people with an interest in computers were usually also interested in science in general, but I guess not.
My opinion is that the use of the word "imaging" in this situation is fraud. Find a physicist and consult with him before you invest.