ACUSON Juniper™ Virtual Touch Quantification (VTq)

ACUSON Juniper* Virtual Touch Quantification (VTq) Quick Reference Card ACUSON Juniper Using VTq to measure shear velocity (Vs) or elasticity (kPa) | Liver Application ACUSON Jumper ................ Step 1 5C1 Step 6 Select 5C1 transducer and • Abdomen Press Update on control panel to • Abdomen exam begin acquisition Step 2 Step 7 Select Elasticity tab on touch screen Elasticity Site 3 When acquisition is complete, Vs E 1.47 m/s • • system automatically freezes and 6.51 kPa Depth 5.6 cm Step 3 displays shear wave measurement Measurement and ROI depth next to image Select Measurement to open Site 1 • .................. measurement label list Step 8 • Step 4 Measurement entered into Report by: Storing image or Print Store 1 - Select desired measurement label Pressing right or left Set key • - Note: If No Label is selected, measurements will appear next to image but will not be Step 9 sent to report or added to overall statistics. Unfreeze, repeat steps 6–8 to make • No Label Site 1 Site 2 Site 3 Site 4 additional measurements in the esion same location in the liver Lesion 2 Lesion 3 Lesion 4 Liver Segment 1 Liver Segment 2 ver Segment 3 ...... . . . . . . . . . . . . . . .. Liver Segment 4A| Liver Segment 4B Liver Segment 5 Liver Segment 6 Liver Segment 7 Liver Segment 8 Step 10 Press Report on control panel • Note: kPa is defaulted On to display Report measurement units in both velocity (m/s) kPa and elasticity (kPa) next to the image ................... (does not affect units displayed in report) Step 11 VIQ Measurement Site 1 View, delete, print, or export VTq • Vs(m/s) Depth(cm) 1.07 4.70 TIP kPa (kilopascal) activation is measurements 2 1.06 4.70 available before or after acquisition 3 1.14 4.70 4 1.05 4.70 Either velocity (m/s) or elasticity 5 1.16 4.70 TIP 6 1.18 4.70 (kPa) can be displayed on the 7 1.27 4.70 Step 5 report – customize before or after 8 1.14 4.70 9 1.46 4.70 report generation under 10 0.99 4.70 Roll trackball to position ROI • > System Configuration Median 1.14m/s Mean 1.15m/s (region-of-interest) > Measurement StdDev 0.13m/s > General IQR 0.11m/s IQR/Median 0.10 > Shearwave Measurement Units *This product is not commercially available. Future availability cannot be guaranteed. SIEMENS Healthineers siemens-healthineers.com/ultrasound HOOD512002740854· © Siemens Medical Solutions USA, Inc., 2018 MI 1.47 TIS 0.7 TIB 1.6 ASC 1 DTCE Med 0.99 m/ VTq Dyn R 63 dB 2.94 kPa THI 5.0 MHZ Depth 4.8 cm 5 dB 24 fps Liver Application 12 cm Fig. 1: Optimal Technique Best Practice Techniques 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 position with right arm raised above head Transducer perpendicular (90°) to skin surface A transducer angle < 50° to the skin surface, or use of inadequate using ample gel amount of gel, can result in artificially low shear wave measure- ments due to loss of transducer contact. Take measurements in right lobe of liver, Optimal ROI placement to obtain reproducible results and avoid in either segment 8 or 5 (Fig. 1), using cardiac motion. intercostal scanning approach Position ROI between 3–6 cm deep (whenever The transducer-specific lens focus is typically about 4–5 cm below possible, position the ROI about 4–5 cm deep the transducer, thus the best measurements are in this region. Avoid for optimal results) and at least 1–2 cm below increased subcapsular reverberation by placing ROI perpendicular the liver capsule (Fig. 1) to and at least 1–2 cm below liver capsule. Optimize B-mode image (Fig. 1) so liver Rib shadows on either side of the ROI result in poor propagation parenchyma is bright and large vessels, of the Acoustic Radiation Force Impulse (ARFI) push pulse. bile ducts and rib shadows are avoided Take measurements during suspended Valsalva or deep inspiration can cause an undesired increase in respiration central venous pressure which can falsely elevate shear wave measurements. Obtain 10 measurements at same site Multiple measurements to ensure the median value is reliable. Maintain an Interquartile Range (IQR) / Indicates variability of measurements lie within reasonable Median Ratio ≤ 0.3 variability range. The recommended quality control measure for adequate technical quality. ACUSON Juniper and Virtual Touch are trademarks of Siemens Medical Solutions USA, Inc. Siemens Healthineers Headquarters Legal Manufacturer & Published by 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.com/healthineers USA Phone: +1-888-826-9702 siemens-healthineers.com/ultrasound Published by Siemens Medical Solutions USA, Inc. · Order No. A91US-465-1C-4A00 · Printed in Germany · 5641 01181. HOOD512002740854· © Siemens Medical Solutions USA, Inc., 2018