Artis VC21

Welcome to this web-based training on the new features in the VC21 software for your Artis system.   You should now be able to: Identify new usablity features   Use the new advanced roadmap feature when performing a roadmap   Identify the differences between the former ICStent and the new CLEARStent procedures   Delete and retrieve studies using the new recycle bin component   List the dose saving components of the new CARE monitor software In VC21 several enhancements have been implemented to improve the workflow and usability of the software. These include new exam task card buttons, touch screen layout improvements, quantification workflow improvements, a new format of the exam set editor, and new features of the series description editor. Roadmap and DSA functions are visible on the on the Settings Tab 512 store monitor images 64 reference images per plane 1024 frames of Store Fluoro With VC14 under the Quant tab, the icons are displayed when the tab is opened. With VC21 all the icons are now located under sub tabs that are clearly marked. Here you can see an example of how all the icons are now located under the calibration sub tab and are clearly identifiable. On the new 3D coronary analysis tab, auto ED Detection is available. Auto ED Detection with VC14 was only available in the control room. Now with VC21 it is available on the touchscreen control module. This feature allows you to select the best diastolic and systolic views.  With Auto ED activated, the next image forward of the ED is displayed. Also with Quantification, new user guided workflows have been incorporated into the sub-menus. This new feature guides the user through the steps of the selected function. Access to the exam set editor is now available via a new button on the exam tab in the control room. The new layout is a tree view and is more structured like the Microsoft Windows explorer. Here you can see the differences between VC21 and VC14 in the Exam Set editor. The icon, layout, and structure all have a new appearance. On the top left of the exam set and program editor there are two buttons which allow you to open and close all exam sets. Also, in order to more easily locate your currently active exam sets, they are marked in bold and the selected Organ program (OGP) is highlighted in blue. When in expert layout, access to the Series Description Editor is available on the TSC Exam task card. The Series Description Editor alows the user to label and pre-label an acquisition with pre, post, left, or right . The editor can also be accessed on the console in the control room using the icon seen in this slide.        TSC Exam Task Card                                       Console To pre-label an acquisition, select an already existing series description. Perform the acquisition and the series description will be displayed in the lower left corner under the exam set name. From the console in the exam tab click on the series descriptions icon, click on the edit list tab. This will show the current list and allow the user to enter or change new or old names as needed. Up to 50 series description can be stored in the Series Description Editor.      Click Icon            Click Edit List              Enter/Change Description               and Select Close & Apply New look and feel, new icon locations. There are also four new features: Roadmap overlay with DSA Images Show Progress Optimal visualization of Vessel/Cathether Change zoom format during RDMP                                             Single Plane Bi-Plane   Touchscreen   Console CLEARstent is the new name for what was termed ICstent in VC12 and 14 software. CLEARStent includes a new online workflow as well as the post-processing workflow available in VC12 and VC14. Recycle Bin allows the user to remove cases from the browser without permanently deleting them. Should a case accidently be deleted, the case can now be retrieved. This feature helps to free up the local database from over-crowding, but does not reduce space on the system. CAREmonitor now factors C-arm angulations, SID movements, zoom changes and collimator adjustments for accurate multi-location skin dose measurements. CAREmonitor will provide real-time visualization of accumulated peak skin dose according to the current C-arm projection and inform the user when to change the C-arm projection to avoid skin burns. On the live monitor, the accumulated skin entrance dose can be seen according to current projection via fill indicator. Every change of c-arm/table/SID/zoom/collimator updates automatically and calculates the accumulated skin entrance dose. The first option, Roadmap overlay with DSA Images, allows you to use any previously acquired DSA Image. For example, this image shows a previous DSA acquisition that could be created as a reference image and then used as a roadmap. New name for Replacement Roadmap (in VC14) Visualize progress of procedure with overlaid vessel map Enables subtracted fluoroscopy mode without Roadmap overlay Possible for Biplane   1. Perform Roadmap and inject glue.   2. When you have injected enough glue and can not determine old from new glue, stop x-ray.   3.Press Show Progress which will reset the mask image and the injected glue will disappear.   4.This process can be repeated as necessary to show progress.   With VC14, changing zoom in roadmap was not possible unless you deselected roadmap. With VC21, roadmap can remain selected and the zoom format can be used. For example, if you were placing a catheter in roadmap with a 16cm zoom format and the catheter kicks out of the selected vessel, you are now able to select a new zoom format in order to view the catheter tip without losing your previous roadmap. Changing the zoom format will still put you into fluoro mode but now you can return to roadmap without interruption. CLEARStent can be found on Touchscreen under the image tab and on the console under the post processing tab task card on the Image subtask card.     Touchscreen Console   CLEARStent's new “online mode”: system displays enhanced stent image or gives option to fade automatically between contrast-filled vessel and enhanced stent image. Provides visual feel of a scene versus a single image. Steps for the CLEARStent online workflow 1.     Prepare the patient, stand, C-arm and table. 2.     Perform a brief fluoroscopy: Check/set SID, zoom, collimation, filters and measuring fields. 3.     Select CLEARstent OGP. "Ready for CLEARstent acquisition" is displayed. 4.     Start acquisition: keep it pressed. Acquisition phase 1 takes place. At the beginning of phase 2, an injection indicator is displayed on the Live screen. 5.      Inject the contrast medium manually. 6.     Stop acquisition when acquisition run is complete. The CLEARStent image is displayed on the active reference screen.   This feature can be enabled and disabled from the General tab in Browser Configuration. To disable this option, select the checkbox next to "Do not move to Recycle Bin“. Keep in mind items in the recycle bin will still take up system storage capacity. The user also has the option of having the "Restore from Recycle Bin“ icon to be located on the patient browser. In the Browser Configuration under the General tab select the icon from the Tool Pool and move it to the Tool Bar. CAREmonitor will only be possible if patient height and patient weight are entered during patient registration. Once patient height and weight is entered and the exam is accepted, the Accept Patient Information pop up box will appear. Select Ok if the information entered is ok. Upon completing this course, you will be able to: Identify new usability features Use the new advanced roadmap feature when performing a roadmap Identify the differences between the former ICStent and the new CLEARStent procedures Delete and retreive studies using the new recycle bin component List the dose saving components of the new CARE monitor software    Block Unit Movements  Radiation Block Block Unit Movements Radiation Block  Exam Set Editor Exam Set Editor  Series Description Editor Series Description Editor  Overlay Reference Overlay Reference  Display Mode Pop-Up   Display Mode Display Mode Touch Screen redesign: square, color coded icons Note: all tabs have Block Radiation and Block Movements icons The Settings tab: re-structured appearance; same options The Exam Tab: only addition is the Roadmap icon The Image Tab: functions have been separated out for easier use The Quant Tab: all calibration methods are located in the calibration icon button The vessel/catheter contrast can be adjusted for Roadmap images during Roadmap phase 3, but not during X-ray. To activate, press the Vessel/Catheter Contrast button and deflect the joystick as shown in the image. On the next three screens, you will see examples of vessel/catheter contrast adjustments. Perform DSA Acquisition, DO NOT move table/C-arm after acquisition Select the opacified image and create a reference image. Select Roadmap from the control console or the TSC (touch screen console), under the Examination task card. Select Overlay Reference from the TSC. Perform fluoroscopy, initial image will be live fluoro. A blank screen will display, but stay on fluoro pedal, until the reference image appears. Release fluoroscopy and fluoro again, while advancing catheter/wire or device. Vessel and Catheter contrast can be adjusted from the TSC from last image hold, if needed. VC100/CC100% is the system default. The joystick has been moved left to increase the catheter contrast to 200%. Vessel contrast adjusted to 50% and the catheter contrast adjusted to 100%. This is ideal for when using half strength contrast. Also ideal when using full strength contrast and the catheter is not visualized.