A little history: Biosound really led this market that was once designed for mobile ultrasound companies. It was a real niche. The systems were bulky, required a cart, Imaging was mediocre, and the probes were usually mechanical or 'wobblers'. But in the 1999 a little company spun off from ATL called SonoSite. They created a system called the SonoSite 180 that was designed for military use: small, battery-operated and very tough. And so it began. The SonoSite 180 was great for triage and emergency scanning and had a huge "wow" factor. From there, it grew. And so did the compact portable ultrasound market. GE had played on the fringes of this market, but jumped in head-first and took over the market with some really outstanding products. Now GE is the leader with almost too many entries (Vivid i, Vivid e, Voluson i, Logiqbook, Logiqbook XP, Logiq e, Logiq i, etc.) For now, we're going to review the two emerging-market and very popular systems: Logiqbook XP and SonoSite Titan. These hit the market with a bang and still run strong as solid, good imaging systems that can be used in many cases, particularly the emerging fields in which ultrasounds are being applied.
The Titan is lighter, smaller, and has less viewing area. LCD displays are 8.4-inches for the Titan and 10.5 for the Logiqbook XP. The Titan weighs-in at about 8lbs compared to the Logiqbook XP's 10.5 lbs. Both have a carrying handle (the XP's is not visible in the picture because it duals as support in the back of the system in case you'd like to prop it at an angle... A nice touch). Other obvious notes are the keyboards... and this is where the differences are very large and ultimately set the tone for the design and use of these machines:
- The Titan's keyboard is more compact, more direct, and backlit (don't take this for granted particularly if you're going to be scanning in a dark room). The buttons are large and easy to read, although the keyboard is small. It has a trackpad/touchpad device (for which SonoSite is being sued by GE) that is easy to use for measurements and the like. It also has softkey controls along the upper portion of the keyboard and just below the monitor.
- The Logiqbooks XP's keyboard is larger, nearly full-size, and more complex. The buttons are smaller and can be considered easier or harder to use depending on your situation (lighting, how much manipulation you'll do, types of exams, etc.). This is clearly designed more like a console-unit, as it attempts to provide many of the keys available on the larger units... but if you don't use the machine very much, it can be a bit confusing in a dark room or hurried situation. All-in-all, the system does not involve rocket science and definitely easier than those of the previous-generation's full console ultrasound machines circa mid-1990s.
The larger keyboard on the Logiqbook XP also makes another feature stand out: customization. This system is more feature-laden, including Auto Tissue Optimization, better Doppler controls, more measurement controls, better TGC control (arguably), and basically more "stuff". Well, that all sounds great until you scan in a dark room and can't remember where everything is. Good luck because the keyboard is, well, full of a lot of great customization controls and a poorly-lit room can make this tough. Whereas the SonoSite's utilitarian and backlit configuration can be quite nice for one who couldn't care less about the infinite ways of optimizing their 2D, color, and Doppler images (SonoSite provides basic controls and really stuck to their target market). I can't imagine the tremendous fights that went on in the user-interface design room for the Logiqbook XP... utilitarian or 'give 'em everything'. They got most of it right, however, they hid the Tissue Harmonics button that is so prominently displayed on all the other machines... is it because the harmonics aren't good on this machine? Possibly. Read on.
The difference in this was quite surprising. While the XP's boot time is still short compared to some console units, it really appears really slow when paired against the Titan (particularly with impatient people such as myself).
- The SonoSite took 8 seconds to boot and was ready for imaging
- The Logiqbook XP took 1:40 to boot and was ready for imaging
The key difference here is the operating system. The Logiqbook XP runs on Windows XP, which allows it quite a bit of versatility and a reliable, tested operating system ready for wireless, USB compatibility, and saves GE time from developing its own OS. The SonoSite runs its own operating system designed specifically for its "point of care" applications such as Emergency Rooms where speed is more important than flexibility. Again, SonoSite focused hard on its target market and stuck with something lean and fast. GE was probably took a more shotgun broad-audience approach here.
Image quality on both machines is quite impressive considering the cost, size, and amount of time these things have been on the market. Both have Tissue Harmonics imaging capabilities... SonoSite, at a glance appears to perform well for penetration (which is the main goal) and Logiqbook's harmonics seem to be better for more superficial imaging. Maybe that's why you must hit CTRL-H in order to turn on harmonics for the Logiqbook (everything else is basically at the touch of a button) ... because its intended function doesn't appear to perform very well.
Overall, we found the penetration to be better on the SonoSite. We were able to scan the carotid of a 300lb man and get good 2D and decent color out of it. We haven't heard many complaints about the penetration with the SonoSite, however, we have had a few comments from our customers from the Logiqbook XP and its limited penetration, particularly in obstetrics and obese patients. To be fair, these comments seem to be based on a higher expectation from those using a full-console unit 90% of the time and using the Logiqbook as a backup unit. I was really quite surprised to see how the penetration lacks when you turn on Harmonics with the Logiqbook XP. This is experienced in abdominal imaging and obstetric imaging... I have not had a chance to take a look with the vascular probe because we recently sold our last one and we need to purchase a replacement. For updates to this, call us at 866-347-7633.
Frame rates in Color Doppler were also surprising with the SonoSite. It responded well with little aliasing in a normal carotid or abdominal study. The Logiqbook was similar, although we didn't test in on a carotid last Friday because we'd sold the linear probe and haven't yet bought its replacement.
Calculations and Measurements
This is a tough call to describe without providing too much bias. Yes, the Logiqbook XP has a much better calculation and measurement package.. However, for most of the users for which the SonoSite is designed, it won't make a huge difference because the basics are there... i.e. if you're only using the system a couple times a week for abdominal, screening, obstetrics or vascular, you really don't need the other stuff. However, you'll get better versatility with the Logiqbook XP. And that goes for the entire system with more customizations for those who like to tweak their images. The XP is more versatile and provides more customization and options, period.
SonoSite wins here in all ways. Everything on this feels tough. I've heard the stories of salespeople dropping the probe and systems on the floor intentionally to prove how tough these things are. The Logiqbook XP ultrasound definitely feels more like a laptop computer, which you do not want to drop. The probe connectors will give you this same feel; the XP seems a bit flimsy compared to the Titan's lock-and-load type system that keeps the connector hidden beneath the machine. However, if you're going to leave the XP on a cart and move it occassionally from room-to-room, do you really care?
Both provide good solutions for connectivity and DICOM, although I'll give the Logiqbook XP an edge because it's definitely more versatile. The Titan gives you the choice of networking or SmartMedia. The XP allows you to use a USB device, wireless and basically anything you would do on your own laptop. Very nice.
It's important to remember that neither of these machines is designed to replace a full console unit, although they do a pretty good job of getting the good stuff in there. These are capable machines, not pieces of crap adapted for a market need. This world is changing and compact ultrasounds are getting darn near the console units (see my previous Voluson e story ). We also love the Logiq e, which has GREAT image quality.
Both the SonoSite and Logiqbook are top-sellers in the market. So how does one decide? Here's how I put it to an internal med doctor last week that inspired this article: You need to decide what you will be doing (what you need), and the decision will present itself. Neither system needs a dedicated procedure room, and both have good carts to which they can be mounted (and easily removed). As an internal medicine doctor, he simply needs to decide how often he'll use it, what types of studies, and who will perform the exams. Answers to these questions will make the answer fairly obvious.
The SonoSite is a great system for those only doing a few exams per week particularly when those ultrasound procedures are not planned in advance. For example, a patient enters a family physician office presenting some abdominal pain. In this situation, simply pull the SonoSite off the shelf and you'll have an image imminently. It'll be a solid image, and likely performed by the doctor who wants to do a quick diagnosis. This is also perfect in Emergency Medicine, Med-Check offices, family practice, internal medicine, and anesthesia.
The Logiqbook XP is something that is more likely to be used by a sonographer or physician with more experience with ultrasound and has a more defined preference in the "look" of their images, presets, and in-general more control over the ultrasound. This system would be found in many of the same places, but has a better fit in an office where patients would likely have their ultrasound scheduled in advance. This allows the system to already be running without too much wait for bootup time. It also requires a better-lit room (until the tech or physician is more comfortable with the user interface) and some basic savvy of ultrasound systems.
Both are very easy to use and learn. For physicians just getting into ultrasound, they should have no problems adapting to either of these systems. They're both very nice. The viewing area didn't seem to have a significant impact on the image quality or evaluating images. Both provide solutions for the doctors to review on their own computer or send to a radiologist.
Overall, you can't really go wrong with either system. Define your needs carefully and the answer to which one is right for you shall present itself. You can also call us at 866-347-7633 for a quote on the system or to get your other thoughts. You can email me as well.
President, GPS Medical Inc