Six Handheld POCUS Devices Compete – Who Wins?

Written by Christopher Thom 

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This was a comparison of 6 handheld ultrasound devices across several domains, including image quality and ease of use. The Vscan Air, Lumify, and Mindray TE Air had the highest image quality, with the Vscan Air being the top pick amongst users.

Not all handhelds image equally
The ultrasound revolution has continued in the 2010s and 2020s with the advent of several cost effective handheld devices. Which is best? A multidisciplinary group of POCUS experts (35) compared performance across three specific views (RUQ, Apical 4 chamber, and superficial neck/lung). Handhelds evaluated included the Vscan Air, Lumify, Clarius, Kosmos, Butterfly iQ+, and Mindray TE Air. Examinations were performed on standardized patients with BMI < 24. Image quality was highest with the Vscan Air, Lumify, and Mindray TE Air in the RUQ and Apical 4 domains. The Mindray TE Air does not have a superficial application, and the Clarius was represented in the top three for the superficial neck/lung image quality. Overall, the Vscan Air had the highest overall ease of use and image quality ratings amongst the users. It was also most frequently identified as the device POCUS users would want in their pocket.

How will this change my practice?
The landscape of handheld ultrasound devices is rapidly evolving. The Vscan Air is the overall winner here. Butterfly iQ+ scored poorly across image quality metrics, though it should be noted that these data were collected prior to the launch of the Butterfly iQ3 probe. While the Vscan Air was highlighted here, the correct handheld for you is likely a multifactorial decision and you should gather hands-on time with these devices before making a final selection. Lastly, I would point out that while the marketplace is rapidly innovating and advertising new AI features on POCUS devices, this cohort of users rated AI as the least important characteristic. This may be secondary to the expert nature of these users, or perhaps many of these AI features are trendy and novel but lacking enough clinical utility to be a real factor in purchasing decisions.

Ultrasound Handheld Pro-Tips:
Handhelds can fill a niche for a variety of clinical users. Expect imaging quality to be lower than cart-based machines, though that gap is closing. Adequate gel and pressure continue to be your best strategies towards good imaging visualization. Many handhelds offer intuitive depth and gain settings, such as swipe functions. Dynamic range and selectable tissue harmonic imaging are not common features on handhelds, though use of the correct imaging mode will maximize these settings. One of the key variables to consider is connectivity. Make sure you understand how the handheld will interact with the tablet and your existing ultrasound workflow as well as the impact of the device’s login requirements. Due diligence is key to success, given the additional variables that are inherent with handhelds.

Source
Comparison of 6 handheld ultrasound devices by point-of-care ultrasound experts: a cross-sectional study. Ultrasound J. 2024 Oct 2;16(1):45. doi: 10.1186/s13089-024-00392-3. PMID: 3935637