Better peek inside

BOTHELL – SonoSite’s portable ultrasound machines have helped doctors from Seattle emergency rooms to field hospitals in Iraq quickly find internal injuries.

Now, the company’s devices also can help prevent an emergency by preventatively checking for signs of coronary artery disease.

It’s one of the ways the Bothell company, which recently introduced its new MicroMaxx model, is trying to make ultrasound technology do more.

The company’s newest software can automatically measure the thickness of the carotid artery’s walls. If the walls of this main artery, located in the neck, have thick layers of plaque, it’s a good indication that arteries in the heart are similarly diseased.

“It really allows people to take a look at coronary health. It allows patients to be treated earlier and for doctors to tailor their treatments,” said Patrick Martin, SonoSite’s director for cardiovascular medicine.

Michael O’Leary / The Herald SonoSite Inc.’s newest portable ultrasound model, the MicroMaxx, can perform scans four times faster than its predecessor.

SonoSite has focused on specialties such as coronary and cardiac health, touting ways its machines can be used to save doctors’ time and the health care system’s money.

For example, a patient who’s worried about cardiac disease, even if they have a low risk, can have a doctor or technician use hand-carried ultrasound for a “quick look,” said Catherine Otto, director of cardiology fellowship programs at the University of Washington Medical Center.

“This takes about five minutes and saves the patient (and our health care system) the cost of a complete echocardiographic study,” Otto said in an e-mail message from Tokyo, where she was traveling last week.

She added that her cardiology department also is using SonoSite’s MicroMaxx to routinely check patients who already have cardiac disease and to rapidly test people who show up at the medical center’s clinic or emergency room with worrisome symptoms.

The MicroMaxx, SonoSite’s third generation of hand-carried ultrasound, is the same size – 8 pounds – as its earlier Titan model. But it features a larger screen and sleeker look.

However, it’s what lies inside the titanium blue case that’s revolutionary, said Kevin Goodwin, SonoSite’s chief executive officer.

“We’ve basically put more and more ultrasound horsepower on a single chip,” he said.

The silicon-chip brains developed for SonoSite’s first models could perform about 6 billion operations per second. The second generation sped up to 10 billion operations.

The combination of chips designed for the MicroMaxx may be able to perform 60 billion operations per second, Goodwin estimated. He guessed it’s taken between $70 million and $85 million over the years to evolve the chips to this point.

“The MicroMaxx is about a four times’ improvement from the Titan. It also signifies a significant milestone in ultrasound-on-a-chip because it’s scaleable,” Goodwin said. “This is the most unlimited chip set we’ve had.”

Which means it’s now easier for SonoSite to shrink a basic ultrasound machine into a device the size as the average PDA, or personal digital assistant. The CEO said he expects SonoSite will roll out a “host of new products” that use the Chip Fusion technology in the next few years.

“It opens up tremendous opportunity,” he said.

The new chips also have improved reliability for SonoSite, which is the only one in the industry to offer a five-year warranty, Goodwin said.

Trying to move its technology forward has helped SonoSite keep larger competitors at bay. When General Electric’s medical division got ready to introduce its own hand-carried device in 2002, analysts waited to see whether the Goliath would significantly cut into SonoSite’s sales.

Three years later, SonoSite holds 60 percent of the market, while GE has captured about 30 percent.

“It was like a speed bump,” Goodwin said of GE’s competition. “It wasn’t a blow.”

He added that SonoSite is big enough to attract engineers as talented as those working for its larger rivals.

SonoSite also will get bigger, relatively quickly, Goodwin added. With a market value of around $500 million now, the company’s goal is to increase that to $1 billion to $1.5 billion in the next three to five years. He wants to see revenue double by 2008.

“It’s not going to be easy. But we think the revenues are there,” Goodwin said.

On the strength of its Titan system, SonoSite saw revenue surge 37 percent in 2004. That helped the company achieve its first full-year profit of $3.7 million before taxes. The company hopes to finish in the black again this year.

Otto said her only concern about the wider use of ultrasound that SonoSite is helping to push along is that health care providers need to be trained to accurately obtain and interpret images. The doctor said she expects that will become a standard part of medical education in the near future.

Martin said that aspect also is kept in mind as the company designs new models. Even as the hand-carried models can do more things, SonoSite is trying to keep them relatively easy to use.

“We’ve always wanted the technician to focus on the patient, to not have to feel like (he’s) flying a 747,” he said.

Reporter Eric Fetters: 425-339-3453 or fetters@heraldnet.com.