The Siemens P500 for veterinary echocardiography
I have tried and reviewed the Siemens P500 ultrasound machine in the past, but this week, I received delivery of my very own brand new unit. To be clear, I will not be replacing my Apogee 2300. The Siui Apogee 2300 is an extremely reliable ultrasound machine that has served me well now for almost 4 years, and even many years on from when I first selected this system as my number one echocardiography machine, it still beats anything else priced under £20,000 in the market today. Competitor systems have not caught up with it and, of course, it continues to be improved and developed all the time. Apogee 2300 models bought today can now come with auto EF and strain software, for example (and older models can have a software upgrade).
My Siemens Acuson P500 machine will not be a replacement, but an addition, that will work well with much of my research work. The Apogee 2300 provides stunning image quality, with fast and easy image and video saving, making interpretation and reporting a breeze. Clinically, that is what I need, and definitely what every veterinarian needs. For my research work, however, I have more time on my hands to delve into the type of detail one could never afford in a normal first opinion examination. I also require easier export in DICOM format than the Apogee 2300 allows: Siemens is one of the ‘big four’ ultrasound companies in the UK and, alongside GE, Philips and Canon, dominates in supplying the NHS. As such, by default, Siemens ultrasound machines are configured to save and export in DICOM format, although avi format is of course available (and will be preferred for the majority of veterinary users).
The anonymisation option is also a huge time-saver for me. When exporting studies, you can simply tick a box to anonymise your study, and give it an anonymisation name if you wish (some people may use a coding system – I just write the breed, “e.g. Anonymous Cockerpoo”). This automatically blacks out the top ID bar for you, resulting in an export like this:
For teaching, though, the Apogee 2300 still wins. On the Siemens machine, to store a video, you press ‘Clip Store’ – but if you freeze and then press ‘Clip Store’, it will save a very long loop (in the order of minutes, if you wish). The downside with this is that it takes a very long time for it to save this long clip – in fact, it seems to take double the time to save the clip than the actual length of the recording. Scanning for 10 seconds but needing to wait 20 seconds before you can continue with your work is impractical in most settings. On the Apogee 2300, however, you can set any key you wish as your continuous record hotkey, and even if you were to scan for 5 minutes straight before stopping it, it would take only a second or two to save.
To be clear, it is only the long loop record feature that is slow on the Siemens machine. This is something that nobody will ever use clinically. For me, though, it is important, as I often want to show people the an entire process from start to finish. To show people how to obtain a mitral inflow trace, for example, this will include finding the right view, turning on and correctly positioning colour Doppler, positioning the pulsed wave Doppler gate, adjusting the gate size, obtaining the trace, adjusting baseline and scale, and optimising gain. All of this requires me to be able to record continuously, often for several minutes at a time. I assume the difference in save speed is due to the fact that the P500 saves this entire clip at the highest possible resolution, without compression, and retaining its DICOM format. In continuous record mode, the Apogee 2300 will save as an avi only (this means you cannot perform any measurements from it later, which is why I say nobody uses this feature clinically), and compresses the clip to the point that it frequently needs to be slowed down in video editing software afterwards.
I was very excited to be the first person in the UK to try the new microconvex probe on the Acuson P500. Indeed, it has been the lack of a microconvex probe that has stopped me buying the P500 before now. While all of my clinical work is in echocardiography, it is still important to me to be able to perform basic abdominal checks, and it’s certainly vitally important to the vets I teach or demonstrate scanners to.
I had the opportunity to try out this new probe right away at the heart clinic last week, when one of our patients came in with ascites (unusually, we could not find a cardiac cause in her subsequent echocardiogram).
Although not the greatest test for a probe, the image quality is clearly very good. The abdominal image quality on the Apogee 2300 is exceptional, and I was keen not to depart from this standard. I will be testing this probe out more thoroughly over the coming weeks, in particular to check the performance of the microconvex probe’s colour Doppler imaging (again, a huge strength of the Apogee machines is their unbeatable colour Doppler performance, easily outperforming rivals like Sonoscape, Chison or Edan).