ARTIS icono VE20 Software Overview - USA

Welcome to the ARTIS icono VE20 Software Overview Online Training. This training module will introduce you to the software of your ARTIS Icono. In particular you will learn about: The control room user interface Patient registration Reviewing and post-processing images Image documentation     Congratulations. You have completed the ARTIS icono Software Overview Online Training course. Listed below are the key points that have been presented. Take time to review the material before you proceed to the final quiz. Download and print a copy of the Course Review. Home Screen You can access the Home screen anytime by selecting the Home icon in the Info area. From the Home screen you can select options to: Return to the examination user interface Lock the workplace Shut down or restart the system User interface The user interface is divided into: The Info Area The Image Area The Segment header  Review controls  Area for Guidance messages ​​Info Area The Info Area is at the top of the control room user interface. ​The Info area shows the most important patient and examination data.  When you click on the items in the Info Area, you can change the data and administrate patients and the system. Segments Images and other information are displayed in segments: Live segment Ref segment 3D Sharing Viewer External   ​Each segment type is demonstrated by a different color. The currently selected segment is outlined with the color of the segment type. You can add icons to the Segment header as favorites. To add an icon to the favorites, right click on the icon in the Segment Menu or in the Settings menu To remove an icon from the favorites, right-click on the icon Patient Registration To register a patient, select the Scheduler from the Info Area. ​Alternatively, you can open the Scheduler by pressing the Scheduler key on the keyboard.  ​The following methods of patient registration are possible:  HIS/RIS registration Manual patient registration Emergency patient registration Patient information is displayed in the Patient Registration window. Mandatory fields are marked with an asterisk. All mandatory fields must be filled to complete the registration. Select a program You select your procedure type during patient registration. The procedure includes an acquisition program and a fluoroscopy or Roadmap program.  Additionally, a Case Flow may be assigned to a procedure.  If you need to change the selected procedure or protocol, select Program Selection from the Info Area. Procedures are divided into body regions; first select the required body region. Then you can select:  The procedure The acquisition protocol The fluoroscopy protocol The fluoroscopy set You can also change the following parameters: Acquisition frame rate Fluoroscopy pulse rate Acquisition scene length Measure field Case Flow Case Flow allows you to assign specific preferences of a user to a procedure. After you select Case Flow, the following settings are automatically applied: X-ray and imaging parameters Exam room display layout C-arm start position Table position Collimation Zoom size Overlay state You select Case Flow from the touchscreen on the Pilot control module.  Store images Acquisition images are automatically stored. Fluoroscopy and Roadmap images are not stored automatically.  ​You can store images as: A Store Monitor image A Reference image Additionally, you can store Roadmap and fluoroscopy scenes.  The store icons are located in the Storing tab of the Segment Menu. ​It is also possible to add the store icons as a favorite to the Segment header. Loading images You can load images to the Live, 3D Sharing or Viewer segments from the current examination or from previous examinations.  The type of image that you can open in a segment depends on the segment type. You load images from the Patient Browser. Each segment has an icon to open the Patient Browser in the Segment header. ​Select the icon to open the Patient Browser in the segment that you want to load the images into. Post processing You can access basic imaging functions with a right mouse click. The options available depend on the selected image type; 2D Angio (DR, DSA) or 3D Volume.  You can find further functions for adjusting the views of a scene or image in the Image tab of the Segment Menu. You find the controls to review images at the bottom of the image segment. To loop all scenes, select Loop in the Image tab of the Segment Menu. To window the image using the mouse, press and hold the middle mouse button in the required image.  To adjust the window center/window brightness, move the mouse up and down.  To adjust the window width/window contrast, move the mouse left and right.  You can also use your keyboard to adjust the window values. Additionally, you can adjust the window values from the Image tab in the Segment Menu.  DSA post processing You can access the functions for adjusting the DSA image in the DSA tab of the Segment Menu. In the DSA menu the following functions are available:  Setting a new mask image Displaying a scene native or subtracted Adjusting the anatomical background Pixel shift Averaging Replacing the maximum fill image Opacification Annotations and measurements You can add text and graphic elements to be overlaid to the scene or image. Additionally, you can measure structures on the image. You access the tools for adding annotations and performing measurements in the Segment Menu:  Annotation tab Measurement tab A calibration must be performed prior to performing measurements. You can calibrate the image via an automatic isocenter calibration, by entering the table-object distance or via a manual calibration method. Exporting images You can export images via the following methods:  Export images to the DICOM network node Export images to CD or DVD Export images to a file system on the system including USB You select the Export icon from the toolbar of the Patient Browser.  The Export Dialog box opens. To export the image:  Select the data for export Select the export target Select the export settings Select Export​   You can load images to the Live, 3D Sharing or Viewer segments from the current examination or from previous examinations. The type of image that you can open in a segment depends on the segment type. You load images from the Patient Browser. Each segment has an icon to open the Patient Browser in the Segment header. Select the icon to open the Patient Browser in the segment that you want to load the images into. Please note: you can also open the Patient Browser by pressing the Browser key on the keyboard.   Rules for loading images Rules for loading images Tab TitleTextLive Segment In the Live segment you can only load images from the current patient. This includes images from current examination and previous examinations. You cannot load images from another patient to the Live segment. If you try to load another patient in the Live segment, a message appears in the image area, advising that it is not possible.    Viewer The Viewer is seen in the control room only. You can load all image types to the viewer; 2D Angio and 3D Volume images. You can load images from the current patient or images from another patient. It is not possible to load 3D images from the current examination to the Viewer. In this case, you will need to open the images in 3D Sharing.   3D Sharing The images displayed in 3D sharing in the control room are synced with the 3D sharing segment on the exam room display.  You can load 3D images from the current examination or from a previous examination to 3D sharing. When loading images from a previous examination, you will see a message that the images will be merged to the current patient. Accept the message to proceed.  Additionally, you can load a 2D secondary capture image of a 3D image in 3D sharing. Further rules When loading images, you should also consider the following: You can open a maximum of two different patients in parallel You can open a maximum of two 2D images at the same time You can open a maximum of two 3D images at the same time All of the above rules include the Live image. If no image has been acquired, one Live image is still accounted for.     You select your program during patient registration. It is also possible to change the program settings during the examination.  Case Flow allows you to assign specific preferences of a user to a procedure. After you select Case Flow, the following settings are automatically applied: X-ray and imaging parameters Exam room display layout C-arm start position Table position Collimation Zoom size Overlay state Case Flow can improve operational efficiency, standardize procedure execution and allow you to concentrate on the clinical procedure and the patient. The system comes with prepared Case Flows for dedicated clinical procedures, for example; TACE, Coronary Diagnosis and Femoral access. You can also add your own Case Flows to procedures. Learn how to select Case Flow Learn how to select Case Flow You select Case Flow from the touchscreen on the Pilot control module.  Each Case Flow is linked to a procedure.  When you select Case Flow on the touchscreen, the Case Flows that are available for the currently selected procedure are displayed. Please note that the learning material is for training purposes only! 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. The information in this material contains general technical descriptions of specifications and options as well as standard and optional features that do not always have to be present in individual cases. 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. Copyright © Siemens Healthcare GmbH, 2019   The Info Area is at the top of the control room user interface. The Info area shows the most important patient and examination data.  When you click on the items in the Info Area, you can change the data and administrate patients and the system.         Learn about the Info Area Learn about the Info Area Slide NumberText BlocksCalloutsAudio ScriptImage File1Scheduler Select the Scheduler in the Info Area to register patients.  In the Scheduler you can:  Register a patient from the HIS/RIS Manually register a patient Register an emergency patient Select the Scheduler in the Info Area to register patients. In the Scheduler you can: Register a patient from the HIS/RIS, manually register a patient or register an emergency patient.2Patient Management The data for the current patient is displayed in the Info Area. When you select the patient data, the Patient Management window opens. In the Patient Management window you can:  Register a new patient Close the patient The data for the current patient is displayed in the Info Area. When you select the patient data, the Patient Management window opens. In the Patient Management window you can: Register a new patient or close the patient.3Layout Gallery The icon for the Layout Gallery is in the Info area. Select the icon to change the layout for the control room display. Additionally, you select the icon to open the Display Layout Configurator. In the Display Layout configurator, you can configure the display layouts for: The exam room display The control room display The icon for the Layout Gallery is in the info area. Select the icon to change the layout for the control room display. Additionally, you select the icon to open the Display Layout Configurator. In the Display Layout configurator, you can configure the display layouts for the exam room display and the control room display. 4Program Selection The currently selected acquisition protocol, fluoroscopy protocol and acquisition parameters are displayed in the Info Area. When you select this area of the Info Area, the Program selection  window opens.  Here you can change the currently selected:  Acquisition plane for Biplane systems Body Region Procedure Acquisition Protocol Fluoroscopy/Roadmap protocol Acquisition frame rate Fluoroscopy pulse rate Acquisition scene length The measure field In addition, you can also select Block X-ray. Please note: This is the only location on the control room user interface to block X-ray. The currently selected acquisition protocol, fluoroscopy protocol and acquisition parameters are displayed in the Info Area. When you select this area of the Info Area, the Program selection window opens. Here you can change the currently selected: acquisition plane for Biplane systems, the body Region, the procedure, the acquisition protocol, the fluoroscopy or Roadmap protocol, the acquisition frame rate, the fluoroscopy pulse rate, the acquisition scene length and the measure field. In addition, you can also select Block X-ray. Please note: this is the only location on the control room user interface to block X-ray. 5Dose Report Dose data for the current patient is displayed in the Info Area. When you select the dose data, the Dose Report opens. Here you can view the preliminary dose report and add comments to the dose report. Dose data for the current patient is displayed in the Info Area. When you select the dose data, the Dose Report opens. Here you can view the preliminary dose report and add comments to the dose report. 6Positions Editor (Organized Stored Positions) The C-arm position and the table position are displayed in the Info Area. Select here to open a more detailed view of the system position and to access the Positions Editor (Organize Stored Positions).  In the Positions Editor you can view and rename the Anatomical positions and System positions. You save the customized system positions from the touchscreen on the Pilot Control Module (PCM). The C-arm position and the table position are displayed in the Info Area. Select here to open a more detailed view of the system position and to access the Positions Editor (Organize Stored Positions). In the Positions Editor you can view and rename the Anatomical positions and System positions. You save the customized system positions from the touchscreen on the Pilot Control Module (PCM). 7Message History The system keeps you updated with the status of the system.  Select the User message on the Info Area to open the Message History.  The messages in this area are particularly important when a system error occurs.   The system keeps you updated with the status of the system. Select the User message on the Info Area to open the Message History. The messages in this area are particularly important when a system error occurs. 8Timer An analog clock is displayed in the Info Area. If you place the mouse over the clock the time is displayed in digital format.  When you select the clock, a Timer is displayed.  Press the play icon to start the timer Press stop to pause the timer When you press start again, the timer is reset and starts timing from zero.  Please note: The timer can also be started from the Pilot control module.   An analog clock is displayed in the Info Area. If you place the mouse over the clock the time is displayed in digital format. When you select the clock, a Timer is displayed. Press the play icon to start the timer. Press stop to pause the timer. When you press start again, the timer is reset and starts timing from zero. Please note: the timer can also be started from the Pilot control module. 9Options In the corner of the Info Area you can access the Options menu. Here you can find the following items: Online Help Remote Assistance Information about the system The Job View User configuration Service and Expert Remote Connect In the corner of the Info Area, you can access the Options menu. Here you can find the following items: Online Help, Remote Assistance, Information About the system, The Job View, User configuration, Service and Expert Remote Connect. Images and other information are displayed in segments: Live segment Ref segment Viewer 3D Sharing External Each segment type is demonstrated by a different color. The currently selected segment is outlined with the color of the segment type.   Learn about the segments Learn about the segments Base ImageHotspotsText BlocksImage FileThe image area Displays the image. The type of image that can be displayed depends on the selected segment type.  Segment header The segment header contains the Patient Browser, the Image Directory, the Settings menu and the Segment Menu.Review controls Controls to review images Learn about the Segment Header Learn about the Segment header Slide NumberText BlocksCalloutsAudio ScriptImage File1Patient Browser In the Patient Browser you can access functions related to patient data management. When loading patient images from the Patient Browser, make sure that you open the browser from the segment that you would like to open the images in.  The Patient Browser has filter functions to search for patients. Enter the patient name in the search bar. Use an asterisk before or after the entry for a wild card search. This will include entries in the search with additional characters at the beginning or the end of the used search term.  Empty the search field by selecting the cross in the search box or by deleting the characters. To return to the full list, press enter again to search all entries.   In the Patient Browser you can access functions related to patient data management. When loading patient images from the Patient Browser, make sure that you open the browser from the segment that you would like to open the images in. The Patient Browser has filter functions to search for patients. Enter the patient name in the search bar. Use an asterisk before or after the entry for a wild card search. This will include entries in the search with additional characters at the beginning or the end of the used search term. Empty the search field by selecting the cross in the search box or by deleting the characters. To return to the full list, press enter again to search all entries. 2Image Directory Images for the currently displayed patient are found in the Image Directory.  If the patient has had more than one examination on the system, first filter the date of the examination.  Select the image type: All, Scenes + 3D, 3D, REF/Bookmarks, Key Images (3D snapshots and store monitor images) and Custom image display.   Select Send To to send images to the PACS.    Images for the currently displayed patient are found in the Image Directory. If the patient has had more than one examination on the system, first filter the date of the examination. Select the image type: All, Scenes + 3D, 3D, REF/Bookmarks, Key Images (3D snapshots and store monitor images) and Custom image display. Select Send To to send images to the PACS. ​3Segment Settings  The options available in the Segment settings depend on the current image type.  You can set the Review mode of the images in the Segment Settings. That is, if the scene should loop or display the last image hold (LIH).  The options available in the Segment settings depend on the current image type. You can set the Review mode of the images in the Segment Settings. That is, if the scene should loop or display the last image hold (LIH). 4Segment menu There are many functions related to image post processing and storing images in the Segment menu. The options available change depending on the currently displayed image.     There are many functions related to image post processing and storing images in the Segment menu. The options available change depending on the currently displayed image. 5Favorites You can add your most frequently used icons from the Segment menu or Settings to the Segment Header.   Right-click on the icon to add it to the favorites  To remove an icon from the favorites, right click on the icon in the Segment Header ​Please note: The favorites are specific for each segment type.  You can add your most frequently used icons from the Segment menu or Settings to the Segment Header. Right click on the icon to add it to the favorites. To remove an icon from the favorites, right click on the icon in the Segment Header. ​Please note: the favorites are specific for each segment type.   You can add text and graphic elements to be overlaid to the scene or image. Additionally, you can measure structures on the image.  You access the tools for adding annotations and performing measurements in the Segment Menu:  Annotation tab Measurement tab Please note: A calibration must be performed prior to performing measurements. You can calibrate the image via an automatic isocenter calibration, by entering the table-object distance or via a manual calibration method.   Learn how to add annotations Learn how to add annotations Tab TitleTextAnnotate with textSelect the Annotation Text icon in the Annotation tab of the Segment Menu.   To add a pre-defined text:  Select the text from the Text annotation list Select the required position on the image To add a free text:  Select the Free Text icon in the workflow header Select the required position on the image Enter the text via the keyboard ​Press Enter on the keyboard to confirm the text Annotate with lines and shapes You can emphasize image details using lines, arrows or shapes. Select the required annotation in the Annotation tab in the Segment Menu and select the area of interest on the image.   You can also use the Pointer function in the control room to place a pointer on the image so that it appears on the exam room display.  Select the Pointer icon in the Annotation tab in the Segment Menu.    Hide/show annotationsIf you do not want to see the annotations or graphics on the images, you can hide them.    Select the Hide/Show annotation icon in the Annotation tab of the Segment menu.    Alternatively, you can right-click on the image and deselect the annotation.    Learn how to perform measurements Learn how to perform measurements Slide NumberText BlocksCalloutsAudio ScriptImage File1You find the measurement tools in the Measurement tab of the Segment menu.You find the measurement tools in the Measurement tab of the Segment menu.2Before you measure an object on the image, you must make sure that the image is calibrated.  There are three methods of calibration: Automatic Isocenter calibration Automatic TOD calibration  Distance calibration Caution: If the image is not calibrated correctly, inaccurate results are possible. Perform the calibration carefully.  Hint: If no calibration is stored for an image with distance measurements, two question marks ?? will be displayed instead of a distance value. Before you measure an object on the image, you must make sure that the image is calibrated. There are three methods of calibration: automatic isocenter calibration, automatic TOD calibration and distance calibration. Caution: If the image is not calibrated correctly, inaccurate results are possible. Perform the calibration carefully. 3Automatic Isocenter Calibration If the organ of interest was placed in the isocenter (the center of rotation) during the acquisition, the system can perform an Automatic Isocenter calibration. Isocenter calibration is automatically preselected for image angles 50° - 130° The system is ready for calibration as soon as you click on the image A message is displayed on the lower part of the image Click on the image to calibrate Confirm with Accept To re-calibrate an image, you can manually start the Automatic Isocenter Calibration.  Select the Auto ISO cal icon in the Measurement tab of the Segment Menu.  ​​Please note: This method of calibration should only be used if you are certain that the organ of interest was in the isocenter during the acquisition. If the organ of interest was placed in the isocenter (the center of rotation) during the acquisition, the system can perform an automatic isocenter calibration. Isocenter calibration is automatically preselected by the system for image angles 50 degrees to 130 degrees. The system is ready for calibration as soon as you click on the image. A message is displayed on the lower part of the image. Click on the image to calibrate. Confirm with Accept. To re-calibrate an image, you can manually start the automatic isocenter Calibration. Select the Auto ISO cal icon in the Measurement tab of the Segment Menu. ​​Please note: This method of calibration should only be used if you are certain that the organ of interest was in the isocenter during the acquisition. Otherwise there can be significant measuring uncertainties.4Table-Object distance calibration If the organ of interest is at a defined distance from the tabletop, you can use the Table-Object distance (TOD) calibration. The system calculates the calibration factor based on the image geometry. TOD calibration is automatically preselected for images with angles 0o- 50° or 130°- 180° 0°- 15° and greater than 165°: enter the TOD and confirm with Accept 15°- 50° and 130°- 165° first click on the Region of interest (ROI) in the image.  Enter the TOD and Confirm with Accept ​​​ To re-calibrate the image, you can manually start the Automatic TOD Calibration:  Select the Auto TOD cal icon in the Measurement tab of the Segment Menu.   If the organ of interest is at a defined distance from the tabletop, you can use the Table-Object distance (TOD) calibration. The system calculates the calibration factor based on the image geometry. TOD calibration is automatically pre-selected for images with angles 0 degrees to 50 degrees or 130 degrees to 180 degrees. For images with angle 0 degrees to 15 degrees and images with angles greater than 165 degrees, you enter the TOD and confirm with Accept. For images with angles 15 degrees to 50 degrees and 130 degrees to 165 degrees, you are prompted by the system to first click on the Region of interest (ROI) in the image. Then enter the TOD and Confirm with Accept. To re-calibrate the image, you can manually start the Automatic TOD Calibration: Select the Auto TOD cal icon in the Measurement tab of the Segment Menu. 5Manual distance calibration If there is an object on the image with a known distance you can use the object to calibrate the image.  Important: The calibration object should be located in the same plane as the object to be measured The calibration object should be larger than the object to be measured For distance measurements it is advisable to calibrate over a distance of at least 3 cm Check that the contrast between the calibrating object and the back ground is good. When the contrast is too low, the pixel size will be inaccurate  If there is an object on the image with a known distance you can use the object to calibrate the image. Important! The calibration object should be located in the same plane as the object to be measured. The calibration object should be larger than the object to be measured. For distance measurements it is advisable to calibrate over a distance of at least 3 centimeters. Check that the contrast between the calibrating object and the back ground is good. When the contrast is too low, the pixel size will be inaccurate.6 Select the Distance Calibration icon in the Measurement tab of the Segment Menu Click on the image to select the starting point Drag the line to the end point Enter in the length of the distance (in mm) Confirm with Accept Select the Distance Calibration icon in the Measurement tab of the Segment Menu. Click on the image to select the starting point. Drag the line to the end point. Enter in the length of the distance (in millimeters). Confirm with Accept.7Measuring distance lines: Select the Measure Distance icon in the Measurement tab of the Segment Menu Click on the image to set the starting point Drag a line to the end point The distance line is drawn showing a number and the distance Measure distance polylines:  Select the Measure Distance icon in the Measurement tab of the Segment Menu Click on the image to set the starting point Drag the line to the first point Click further points Double-click on the end point As soon as the end point is set, a polyline curve and the distance are shown To measure distance lines: Select the Measure Distance icon in the Measurement tab of the Segment menu. Click on the image to set the starting point. Drag a line to the end point. The distance line is drawn showing a number and the distance. To measure distance polylines: Select the Measure Distance icon in the Measurement tab of the Segment menu. Click on the image to set the starting point. Drag the line to the first point. Click further points. Double click on the end point. As soon as the end point is set, a poly-line curve and the distance are shown.8Angle measurement The system determines the angle between the two drawn lines clockwise. If the angle is larger than 180°, the program subtracts 180° from the angle.  If both sides have been drawn in the direction of the point of intersection, angle A is displayed. If both sides have been drawn away from the point of the intersection, angle A is displayed. Otherwise, angle B (A-180°) is displayed. The system determines the angle between the two drawn lines clockwise. If the angle is larger than 180 degrees, the program subtracts 180 degrees from the angle. If both sides have been drawn in the direction of the point of intersection, angle A is displayed. If both sides have been drawn away from the point of the intersection, angle A is displayed. Otherwise, angle B (angle A minus 180 degrees) is displayed.9Drawing and Measuring angles Select the Angle icon in the Measurement tab of the Segment Menu Click on the image in the start point and drag the line to the end point of the first line Click on the image in the start point and drag the line to the end point of the second line To draw an angle: Select the Angle icon in the Measurement tab of the Segment Menu. Click on the image in the start point and drag the line to the end point of the first line. Click on the image in the start point and drag the line to the end point of the second line.   Learn about the Image Tab Learn about the Image Tab Base ImageHotspotsText BlocksImage FileEdge enhancement Use the slider to adjust the value from 0% to 100%. Greater edge enhancement creates sharper edges and more noise. Reduce the edge enhancement value for softer edges and less noise.  Windowing Select the icon to open sliders to adjust the window values. You can also window images using the mouse or your keyboard.Shutter Select the shutter icon to hide unimportant details outside the center of the image. Zoom/pan Select the zoom/pan icon to zoom by a factor of two. To pan the image when Zoom/pan is active, click on the image and drag to position.Horizontal flip Select the Horizontal flip icon to flip the image in the horizontal axis. Take care when using image flip to ensure the correct labelling of images. Vertical flip Select the Vertical flip icon to flip the image in the vertical axis. Take care when using image flip to ensure the correct labelling of images. Acquisition size Select this icon to zoom the image to the acquisition size.Invert Select this icon to invert the image gray scale, where bones black become bones white and vice versa.Looping through all scenes Select this icon to review the study so that scenes are played one after the other.   Learn how to flip fluoroscopy images Learn how to flip fluoroscopy images You can find the icon to flip real-time fluoroscopy images on the touchscreen of the Pilot control module under Settings. Upon successful completion of this course, you will be able to:   ​Recognize the common features of the software user interface   Register a patient   Select a program   Store images   Post-process images   Export images You can access the Home screen anytime by selecting the Home icon in the Info area. From the Home screen you can select options to: Return to the examination user interface Lock the workplace Shut down or restart the system   Learn about the Home screen Learn about the Home screen Base ImageHotspotsText BlocksImage FileSystem Messages Displays system messagesExamination Return to the examination user interfaceLock Locks the workplacePower icon Provides options to shut down or restart the system Images acquired as an acquisition are automatically stored. Fluoroscopy images are not stored automatically. You can manually store fluoroscopy and Roadmap images as a store monitor image, a reference image or as a scene.