Editor’s Note: I am indebted to Stuart Miller of Haverin on Substack for the initial and later follow up (linked below)  articles on this, plus our exchanges. Feel free to read his first essay first and return here for a further discussion of both Midjourney Medical and Butterfly Network, plus his second article referenced in Part 2.

Part 1: Midjourney Medical and the Prototype Scanner

Can the reality match the hype that’s jumped the rails? Midjourney Medical is a new company (or division) that grew out of Midjourney, a organization claiming to be a “community-funded lab of 60 people known for building the most beautiful AI models in the world”. Moving past the breathless prose, Midjourney Medical has developed a prototype of a whole-body scanner that, unlike present CT scanners and MRIs, does two major things: it fully scans the body in a minute and there is no radiation. The methodology is almost Star Trek-ian: your body is lowered gently into a circular tank of warm water, and 40 chips arrayed in a ring generate waves that change shape when they meet parts of your body (e.g. from skin to fat to muscle to bone).  The waves generated by the chips are translated into  ultrasound computed tomography (USCT) creating a 3D map of a human body, with the completion goal at 60 seconds of scanning and computing time.

This is coming from a 1st generation prototype. The images in the announcement video are supposedly not AI-generated but actual from about a dozen subjects. The actual timing is about 20 minutes at present, a real time not in the announcement but in articles (see below), and the subjects were uniformly slim.

Yet it’s audacious as all get-out, in a time drowning with incrementalism and no Big Next Thing.

If the results from the prototype are real and the timeline/vision are achievable, the potential is stunning. Being lowered briefly into a tank of water is a far more pleasant experience than the tube and noise of an MRI, though for claustrophobics or just those afraid of being submerged in water, the fears are similar. If taken to its logical development, it could, in fact, threaten the business of nearly all of the mainline MRI/CT scan companies such as GE Healthcare, Philips, Siemens, and Canon if it is medically validated and gains FDA clearance.

As Stuart Miller pointed out and described well in his article, there is already an FDA-cleared water/sensor array for USCT used as a diagnostic adjunct for dense breast mammography–SoftVue, developed by Delphinus Medical Technologies of Novi, Michigan. So there is precedent, one already in place and accepted in mainstream medical practice. A device that every woman would accept as standard instead of current.

However, breast scanning does not go through bone (e.g. ribs) nor gas (lungs), which is USCT’s drawback. At present, when ultrasound is used, a trained technician has to work the device between the ribs a millimeter at a time to gain an unblocked view, not in 60 seconds but taking 60 minutes or more.

Midjourney Health’s ambitions are wellness, not medical grade, at least into 2028. The announcement states that this prototype is the first of three.

• Their roadmap is that by end of 2027, Midjourney’s will open a 24/7 medical spa in San Francisco, with the 2nd generation prototypes providing detailed body composition maps for clients, accumulating data for its own case, scanner development, and yes, FDA.
• 2028 would introduce a 3rd generation scanner with custom chips and a ‘night-and-day’ change in image quality and scan times.
• The trajectory is opening proprietary medical spas, staying within ‘general wellness’ permitted by FDA, and gaining acceptance of the technology.
• Ultimately, by 2031, the plan is “to have a fleet of over 50,000 scanners worldwide – with a total scanning capacity of a billion scans a month”. The rationale: early imaging without symptoms>>change in lifestyle>>avoidance of 30% of deaths and 50% of healthcare costs.

Mr. Miller’s skepticism in his article is well presented and warranted. He details that ultrasound can’t go through bone and gas, dunking has psychological and physical drawbacks such as consistently clean water, the ability to run spas at scale, the business drawbacks of no reimbursement, no billing codes, no FDA validation. Unless it is priced well, the Midjourney vision of a pop-in spa and wellness checks  will be confined to the early adopters and the affluent curious privately paying up to thousands of dollars for the experience, much as whole-body MRIs, also in the ‘general wellness’ category away from FDA scrutiny, are today. Can spas support 50,000 scanners? Not likely.

It all sounds rather vague and glossy in a song that this Editor has heard before in the digital health (IBM Watson Health circa 2012) and concierge practice areas.

What is also scarce in this announcement is that once you have this information, what do you do with it? Is it conclusive enough to take to a physician and do follow up?  Or if lifestyle, will these spas affiliate with clinicians who can do the counseling? From the Forbes article on the announcement:

“Whole-body screening of people with no symptoms turns up incidental findings in 20% to 40% of scans, yet only a small fraction ever require treatment, as University of Michigan radiologists have noted. At a billion scans a month, even modest rates imply hundreds of millions of ambiguous results a year, each one demanding a clinical decision and producing a worried customer.”

In the category of ‘it does what it says it does”–a must in generating credibility for a new technology–false positives or even ambiguity are killers.

Since Midjourney Medical is a separate community-backed research lab, they are seeking support from the ‘community’ and not, at this point, explicitly seeking investors. There are reports that the company generates hundreds of millions of dollars in annual recurring revenue, according to Mobihealthnews. Their substantial funding needed for development, chips, and spas has to come from somewhere, and this vagueness about their funding disturbs this Editor.

What Midjourney Medical has in spades is strong skills in generating press coverage. Besides Stuart Miller’s Substack article on 19 June, Mobihealthnews published their take the same day, along with a wave of articles over the next ten days from Radiology Business to Fox News’ Cyberguy to Futurism. The Verge’s 23 June critique proved to be a lengthy deflation. While it presented Midjourney’s side by interviewing their head of medical Tom Calloway, the bulk of the article consisted of far more critical comments from several imaging and radiology professionals. Matthew Davenport, a professor of radiology at the University of Michigan Medical School, said that (FTA) published images were “interesting” and that he could see a market for body imaging. But the company’s “claims are wildly unsubstantiated, perhaps the most grandiose” he has seen. William Morrison, a radiology professor at Thomas Jefferson University, was downright scathing calling it a “vibe-based rollout” and (FTA) that the whole move, he said, has the feel of an ad campaign. “It makes me think that this may be more of a grift than a pivot.” Words like “grandiose” and “grift” tend to stick. 

Part 2: Butterfly Network, Their Chips, and the Agreement with Midjourney

Midjourney Medical had a partner in this which, interestingly, was not mentioned in the announcement. Our Readers may be familiar with the name Butterfly Network. (more…)