ACUSON Juniper™ eSie Touch Elasticity Imaging

ACUSON Juniper eSie Touch Elasticity Imaging Quick Reference Card ACUSON Juniper Using eSie Touch elasticity imaging to qualitatively assess relative tissue stiffness SIEMENS> ACUSON Jumper ... . . .... . . . . . . . . . . . . . . . . .. Step 1 Elasticity Position patient to obtain perpendicular plane to skin • 16L4 surface for optimal axial motion. Thyroid MI 0.99 Position compatible transducer* over area of interest TIS 0.1 • TIB 0.1 SC 2 and optimize B-mode image. DTCE Med Dyn R 65 dB THI 10.7 MHZ Select Elasticity tab on touch screen. 1 dB • 14 fps QF 70 Roll trackball to position 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 (located above the grayscale bar) represents the range of gray or color shades available 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. Step 2 Breast MI 1.17 Use minimal compression; avoid lateral or rocking TIS 0.2 • TIB 0.2 SC 2 motion. DTCE High Dyn R 68 dB THI 8.4 MHZ -2 dB 11 fps TIP Patient respirations or cardiac motion may be sufficient. QF O 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. Fig. 2: A gray overlay box on the elastogram indicates insufficient or A QF value > 60 (Fig. 1) indicates minimal global motion artifact. excessive axial motion or, lateral movement. A QF value < 50 (Fig. 2) indicates a less than optimal result; perform another acquisition. ............................................................ . . . .......... Step 3 5C1 > 16L4 1213 Add Exam Scan ~10 seconds, and then press Freeze; review cine 2D Elasticity SieScan • to obtain desired frames. eSie Touch > Rotate Zoom on the control panel to adjust the view scale. • If desired, select EI Color to select a color map. • If desired, select EI Map Index: Screen LUR Flip Split • 0: Standard default map Hide Patient El Map Index - 1: Normalized map (compensates for non-uniform image - Exit stress applied with transducer) 2: Inverted map - Select Exit to exit elasticity imaging. • *eSie Touch elasticity imaging is compatible with 16L4, 12L3, 11L4: Breast, Thyroid; 18H5: Thyroid SIEMENS Healthineers siemens.com/ultrasound Measurements Shadow Duplicates and displays a measurement on the adjacent image for a comparison of lesion size and/or location. Shadow On a live or frozen image, press Caliper. • Select Shadow. • Measure the right or left image. • TIP Shadow may be used with the Select Caliper to exit measurements. strain ratio or EI/B ratio. • Strain Ratio Compares the relative stiffness of tissue within two ROIs (e.g., compares average strain of a lesion and average strain of the surrounding tissue). % On a frozen image, press Caliper. Strain Ratio • Select Strain Ratio. Strain ratio = 1: • Place ROI 1 (ellipse) in surrounding tissue and press Set key. stiffness of tissue in both ROIs is equal. • Strain ratio > 1: Place ROI 2 (ellipse) in lesion (same size and at same depth) and press • lesion is harder than surrounding tissue. Set key. Strain ratio < 1: Note: ROI size may be adjusted by rotating Select rotary control located on the control panel. lesion is softer than surrounding tissue. Strain ratio and average strain (%) for both ROIs are displayed in the Note: Results reflect placement of ROI 1 in surrounding tissue; results will differ if ROI 1 measured results. is placed in lesion. Note: Strain Ratio is not available when using EI Color. Distance Ratio or Area Ratio Elasticity imaging /B-mode (EI/B) ratio May be used as an indication of the likelihood of malignancy in breast lesions. When the ratio is > 1, the probability of malignancy is very high.* On a frozen image, press Caliper. More • Select More. % • Select Dist Ratio or Area Ratio. Dist Ratio Area Ratio • Measure lesion on elastogram and press Set key. • A 0.31 cm 2 Measure lesion on B-mode image. • B 0.11 cm 2 A/B The EI/B ratio is represented by the A/B ratio in the measurement 2.81 • BIA 0.36 display area. (A-B)/A 0.64 * Barr, R.G. (2010). Real-Time Ultrasound Elasticity of the Breast. Ultrasound Quarterly, 26(2), 61-66. doi:10.1097/RUQ.0b013e3181dc7ce4. ACUSON Juniper and eSie Touch are trademarks of Siemens Medical Solutions USA, Inc. 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, USA siemens.com/healthineers Phone: 1-888-826-9702 siemens-healthineers.com/ultrasound Published by Siemens Medical Solutions USA, Inc. · Order No. A91US-488-1C-4A00 · Printed in Germany · 5641 02181. · © Siemens Medical Solutions USA, Inc., 2018