ACUSON Redwood™ Ultrasound System Virtual Touch™ Strain Imaging

ACUSON Redwood ultrasound system Virtual Touch Strain Imaging Quick Reference Card siemens-healthineers.com/ultrasound Using Strain imaging to qualitatively assess relative tissue stiffness. Step 1 VT Strain • Position patient to obtain perpendicular plane to skin surface for optimal axial motion Breast TIB <0.1 TIC <0.1 • Position compatible transducer1 over area TIS <0.1 MI 1.04 of interest and optimize B-mode image 16 fps 2D • Press VT (Virtual Touch) located on control TEQ 0 dB panel DR 62 LD 1 UA 2 • Select Strain Color 1 Map 2 • Roll trackball to position the region of interest (ROI) • Press Set key and roll trackball to resize ROI Note: The B-mode image and elastogram display in live, dual format (Fig. 1). The elasticity imaging bar represents the range of gray or color shades available 5cm OF : 95 for depicting tissue stiffness from SF (soft) to HD (hard). Fig. 1: Left: B-mode image with ROI. Right: B-mode image with corresponding ROI displaying elastogram. 1 Strain imaging is compatible with 18L6, 14L5, 10L4: General, Breast, Thyroid; 9EC4: General, Prostate SIEMENS Healthineers HOOD05162003029247 14-Oct-2019 Virtual Touch Strain Imaging Step 2 TIC 0.16 • Use minimal compression; avoid lateral or MIO. 98 rocking motion 16 fps 98% 2D Tip: The natural compressions generated by patient’s H High 0 dB respirations or cardiac motion may be sufficient to DR 60 LD 2 generate elastogram. Strain Color 1 Map 1 • Adjust axial motion or cease lateral movement if gray overlay box appears on elastogram (Fig. 2) • Maintain QF > 50 Note: The system displays a real-time quality factor (QF) score. A QF value > 60 (Fig. 1) indicates minimal global 2.5cm OF : 0 motion artifact. A QF value < 50 (Fig. 2) indicates a less than optimal result; perform another acquisition. Fig. 2: A gray overlay box on elastogram indicates insufficient or excessive axial motion or, lateral movement. Step 3 A 2 18L6 ៛ 14L5 10L4 5C1 Breast + Add Exam Workflow Patient 20 • Scan ~ 10 seconds, and then press Freeze; VI review cine to obtain desired frames Review Strain SWE Rotate Zoom on the control panel to adjust Report • the view scale End Exam • If desired, rotate EI Color to select a color map Live Dual • If desired, rotate EI Map Index: 1: Standard default map - 2: Normalized map (compensates for Frequency El Color - HMid El Map Index non-uniform stress applied with transducer) 3: Inverted map - 2 siemens-healthineers.com/ultrasound HOOD05162003029242 · 14-Oct-2019 Measurements Shadow Shadow Duplicates and displays a measurement on the adjacent image for a comparison of lesion size and/or location. • In Live Dual, press Caliper and then select a measurement tool • Select Shadow on the touch screen to activate • Measure either image (measurement displays in measured results) Tip: Shadow may be used with the strain ratio. Strain Ratio Compares the relative stiffness of tissue within two ROIs Strain Ratio (e.g., compares average strain of a lesion and average strain of the surrounding tissue). Strain ratio = 1: On a frozen image, press Caliper and then select Strain Ratio stiffness of tissue in both ROIs is equal. • • Place ROI 1 (ellipse) in surrounding tissue inside ROI Strain ratio > 1: lesion is harder than surrounding tissue. • If desired, rotate ROI Diameter to resize and press Set Strain ratio < 1: • Roll trackball to place ROI 2 (ellipse) in lesion (same size and lesion is softer than surrounding tissue. at same depth) and press Set Note: Results reflect placement of ROI 1 in surrounding tissue; results will differ if ROI 1 is placed in lesion. • Strain ratio and average strain (%) for both ROIs are displayed • To display the measurement in the report, select a measurement label Note: Strain Ratio is not available when using Color 2 or 3. Elasticity imaging/B-mode (EI/B) ratio El/B Ratio - D El/B Distance Ratio 1.43 • On a live or frozen Live Dual image, press Caliper El/B Ratio - D D (E) 5.44 mm D (B) 3.81 mm • Select EI/B Ratio – A (area ratio) or, Select EI/B Ratio – D (distance ratio) % El/B Ratio - A • El/B Area Ratio 1.41 0.10 cm2 Measure lesion on elastogram and press Set key El/B Ratio - A A (E) • A (B) 0.07 cm2 • Measure lesion on B-mode image and press Set key • The EI/B ratio is displayed in the measured results • To display measurement in report, select a measurement label Note: May be used as an indication of the likelihood of malignancy in breast lesions. When the ratio is > 1, the probability of malignancy is increased.1 1 Barr, R. G., De Silvestri, A. , Scotti, V. , Manzoni, F. , Rebuffi, C. , Capittini, C. and Tinelli, C. (2019), Diagnostic Performance and Accuracy of the 3 Interpreting Methods of Breast Strain Elastography: A Systematic Review and Meta-analysis. J Ultrasound Med, 38: 1397-1404. doi:10.1002/jum.14849 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. · HOOD05162003029242 · 14-Oct-2019 · Order No. A91US-620-1C-4A00 · Printed in Germany · 7728 0520 ©Siemens Medical Solutions USA, Inc., 2020