ACUSON Redwood™ Virtual Touch™ Point Shearwave Elastography (pSWE)

ACUSON Redwood ultrasound system Virtual Touch pSWE Quick Reference Card siemens-healthineers.com/ultrasound Using point shear wave elastography (pSWE) Tip: Either Velocity (m/s) or Elasticity (kPa) can be displayed on to measure shear velocity (Vs) in meters per the report – customize before or after report generation second (m/s) or elasticity (E) in kilopascal (kPa) | under: System Configuration > Measurement & Report Liver Application > Measurement > Settings > General > Shearwave Measurement Unit. Step 1 5C1 Step 4 Abdomen • Select compatible transducer1 and • Roll trackball to position ROI Abdomen exam preset (region-of-interest) Step 2 Step 5 Update VT • Press VT (Virtual Touch) located on • Press Update on control panel to control panel begin acquisition Step 3 PSWE Step 6 Site 1 Vs E 1.31m/s 5.17kPa • pSWE is default application • When acquisition is complete, system Depth 4.3cm automatically freezes, emits one • Site 1 is default measurement label audible “beep” and displays shear wave • If desired, select an alternate label measurement and ROI depth next to Note: If No Label is selected, measurements image will appear next to image but will not be sent Note: During freeze, a cooling timer indicates remaining seconds to report or added to overall statistics. until transducer is available for image acquisition. During a short cooling time (e.g., ~ 2 seconds depending on ROI depth), the timer 1 pSWE imaging is compatible with 5C1, 4V1: General, Abdomen; appears and then disappears very quickly. 10L4: Abdomen SIEMENS Healthineers HOOD05162003029247 · 14-Oct-2019 Virtual Touch pSWE Step 7 To enter measurement into report: • Press Image to store image or, Clip • Press right or left Set key Image Step 8 • Unfreeze, repeat steps 5–8 to make additional measurements Freeze Step 9 Report • Select Report on left side of touch screen • View, delete, store, print or export shear wave measurements Shear Wave Report (pSWE) Site 1 Site 2 Vs(m/s) Depth(cm) Vs(m/s) Depth(cm) 1 0.91 4.30 0.83 4.30 2 0.97 4.30 1.24 4.30 3 1.07 4.30 0.87 4.30 4 1.00 4.30 0.96 4.30 5 0.94 4.30 1.25 4.30 6 0.92 4.30 0.84 4.30 7 0.91 4.30 0.95 4.30 8 0.98 4.30 0.96 4.30 9 0.89 4.30 1.04 4.30 10 1.20 4.30 0.98 4.30 Median 0.96m/s 0.96 m/s Mean 0.98 m/s 0.99 m/s StdDev 0.09 m/s 0.15 m/s IQR 0.09 m/s 0.17 m/s IQR/Median 0.09 0.18 Overall Statistics Median 0.96 m/s Mean 0.99 m/s StdDev 0.12 m/s IQR 0.09 m/s IQR/Median 0.09 Note: Shear Wave Speed and Elasticity values may vary among manufacturers 2 siemens-healthineers.com/ultrasound HOOD05162003029247 · 14-Oct-2019 Best Practice 5CT Abdomen TIB 1.43 Site 1 TIC 0.90 Vs 0.82m/s TIS 0.43 2.03kPa MI 1.30 Techniques Depth 4.0cm 36 fps 98% Mid PSWE - 7 cm Site 1: 1 Valid / 1 Total Fig. 1: Optimal Technique for Virtual Touch pSWE liver application. Fasting for 4–6 hours In the non-fasting state, the liver can have falsely increased values. Position patient supine or slight (30°) left Optimal positioning to improve intercostal access. lateral decubitus with right arm raised Transducer perpendicular (90°) to skin A transducer angle < 50° to the skin surface, or use of inadequate surface using ample gel amount of gel, can result in artificially low shear wave measurements due to loss of transducer contact. Take measurements in right lobe of liver, Optimal ROI placement to obtain reproducible results and avoid cardiac in either segment 8 or 5 (Fig. 1), using motion. intercostal scanning approach Position ROI between 3–6 cm deep The default ROI depth best represents the transducer-specific lens (use default ROI depth whenever focus for that transducer; thus, the best measurements are in this possible for optimal results) placing region. Avoid increased subcapsular reverberation by placing ROI the 2 cm cursor depth marker at, or perpendicular to and at least 1–2 cm below the liver capsule. below, the liver capsule (Fig. 1) Scanning parallel to ribs and in an Rib shadows on either side of the ROI result in poor generation and intercostal space to avoid rib shadow propagation of the shear wave from the Acoustic Radiation Force artifacts, optimize B-mode image (Fig. 1) Impulse (ARFI) push pulse. so liver parenchyma is bright and large vessels, bile ducts and rib shadows are avoided Perform acquisition during suspended Valsalva or deep inspiration can cause an undesired increase in central respiration; patient may resume normal venous pressure which can falsely elevate shear wave measurements. breathing after audible “beep” is heard Instruct patient to breath normally and then to momentarily stop breathing during acquisition. When acquisition is complete, the system freezes and emits one audible “beep”; resume normal breathing. Obtain 10 measurements at same site Multiple measurements to ensure the median value is reliable. Maintain an Interquartile Range Indicates variability of measurements lie within a reasonable range. (IQR) / Median Ratio ≤ 0.3 It is the recommended quality control measure for adequate technical quality. HOOD05162003029247 · 14-Oct-2019 siemens-healthineers.com/ultrasound 3 For the proper use of the software or hardware, please always use the Operator Manual or Instructions for Use (hereinafter collectively “Operator Manual”) issued by Siemens Healthineers. This material is to be used as training material only and shall by no means substitute the Operator Manual. Any material used in this training will not be updated on a regular basis and does not necessarily reflect the latest version of the software and hardware available at the time of the training. The Operator Manual shall be used as your main reference, in particular for relevant safety information like warnings and cautions. Note: Some functions shown in this material are optional and might not be part of your system. Certain products, product related claims or functionalities described in the material (hereinafter collectively “Functionality”) may not (yet) be commercially available in your country. Due to regulatory requirements, the future availability of said functionalities in any specific country is not guaranteed. Please contact your local Siemens Healthineers sales representative for the most current information. The reproduction, transmission or distribution of this training or its contents is not permitted without express written authority. Offenders will be liable for damages. All names and data of patients, parameters and configuration dependent designations are fictional and examples only. All rights, including rights created by patent grant or registration of a utility model or design, are reserved. ACUSON Redwood and Virtual Touch are registered trademarks of Siemens Medical Solutions USA, Inc. Siemens Healthineers Ultrasound owns the rights to all images. Siemens Healthineers Headquarters Legal Manufacturer Siemens Healthcare GmbH Siemens Medical Solutions USA, Inc. Henkestr. 127 Ultrasound 91052 Erlangen, Germany 22010 S.E. 51st Street Phone: +49 9131 84-0 Issaquah, WA 98029, siemens-healthineers.com USA Phone: 1-888-826-9702 siemens-healthineers.com/ultrasound Published by Siemens Medical Solutions USA, Inc. · HOOD05162003029247 · 14-Oct-2019 · Order No. A91US-621-1C-4A00 · Printed in Germany · 7729 0520 ©Siemens Medical Solutions USA, Inc., 2020