PEPconnect

Luminos Agile MAX Turnover Workbook

Luminos Agile MAX Turnover Workbook - Onsite applications initial turnover

O SIEMENS Luminos Agile Max Luminos Agile Max VE10 and Higher Turnover Workbook SIEMENS Healthineers www.siemens-healthineers.us I. Contact Information Summary Welcome to Siemens Healthineers PEPconnect Clinical Training and Continuing Education a personalized education experience with options to manage an institution’s workforce education and Customer Care Center - Clinical Application Support: performance growth. Call 1-800-888-7436 pep.siemens-info.com Troubleshooting assistance • Immediate assistance for software • applications and workflow issues Please provide the Functional Location Number when • calling for assistance. Clinical Education Offerings: Call 1-888-221-8010 (follow the prompts) Classroom Training (Offerings, Registration • & Scheduling) Educational Symposia • On-site Training • Printed Self-studies • Virtual Education (Offerings & Registration) • Workshops & Fellowships • Siemens Training Centers Siemens Clinical Education Training Center – TDC2 110 Mac Alyson Court Cary, NC 27511 2 II. Contents I. Contact Information Summary .....................................................................................................................................2 II. Contents ............................................................................................................................................................................3 III Course Overview ..............................................................................................................................................................4 1. System Overview .............................................................................................................................................................. 5 1.1 Generator Console .........................................................................................................................................5 1.2 Emergency Stop .............................................................................................................................................5 2. Hardware Features ..........................................................................................................................................................6 2.1 Detectors ........................................................................................................................................................ 6 2.2 Patient Table with Wireless Mobile Detector ......................................................................................10 2.3 Parking and Unparking the Digital Imaging Tower (DIT) ................................................................12 2.4 Digital Imaging Tower (DIT) ....................................................................................................................13 2.5 Touch User Interface (TUI) .......................................................................................................................17 2.6 3D Tube with MaxTouch Display ........................................................................................................... 20 2.7 Wall Stand ................................................................................................................................................... 24 3. FLC and Performing Patient Exams ..........................................................................................................................25 3.1 General Workflow ...................................................................................................................................... 25 3.2 Overview ...................................................................................................................................................... 25 3.3 Patient Tab ................................................................................................................................................... 25 3.4 Exam Tab ...................................................................................................................................................... 28 3.5 Postprocessing Tab .....................................................................................................................................31 3.6 Documentation Tab .................................................................................................................................. 33 4. PEX Editor ........................................................................................................................................................................35 4.1 PEX Editor Overview .................................................................................................................................. 35 4.2 Opening PEX Editor ................................................................................................................................... 35 4.3 Exam Tab ...................................................................................................................................................... 36 4.4 Organ Program Tab ................................................................................................................................... 38 4.5 Param Module Tab .................................................................................................................................... 39 4.6 Configuration Tab ...................................................................................................................................... 39 5. User Settings ...................................................................................................................................................................41 5.1 Overview ........................................................................................................................................................41 5.2 DICOM Properties .......................................................................................................................................41 5.3 Site Info ......................................................................................................................................................... 42 5.4 Image Delete and User Initials Notes ................................................................................................... 42 6. MAX Swap .......................................................................................................................................................................43 6.1 Attaching and Detaching Detectors ...................................................................................................... 43 6.2 Switching Between MAX Wi-D and MAX Mini .................................................................................... 45 7. Quick Info .........................................................................................................................................................................46 7.1 Abbreviations ............................................................................................................................................... 46 7.2 Status Messages and Display ................................................................................................................. 46 7.3 Cleaning ........................................................................................................................................................47 7.4 Technical Data ............................................................................................................................................ 48 8. Troubleshooting .............................................................................................................................................................50 8.1 System Movements and Functions ........................................................................................................ 50 8.2 SID Tracking ................................................................................................................................................ 50 8.3 Collimation ..................................................................................................................................................51 8.4 The Message Field ......................................................................................................................................51 3 III Course Overview Learning Objectives Upon completion of this course, you will be able to: Correctly perform start-up and shutdown procedures • Identify the key hardware features of the Luminos Agile Max • Describe and utilize the key features of the Fluorospot Compact Imaging System • Identify the MAX features of the system • 4 Turnover Workbook | Luminos Agile Max - VE10 and Higher 1. System Overview 1.1 Generator Console Notes SIEMENS On STOP ---- Switching On/Off System The Agile system is started from the switched off mode • The X-ray room and Fluorospot Compact are switched on and off by the • buttons located on the generator console. Starting the system from the off state Switch On the main circuit breaker in the room. • Press the ON button on the Generator ON/OFF console. • The system performs a self-test of the Fluorospot Compact and Agile - systems. Rebooting the System • Press the OFF button on the console - When the FLC has shut down (dark monitor), press the ON button - We recommend a daily reboot of the system. Making an Exposure When all parameters are set and you are ready to make an exposure, make sure you see the Ready symbol on the bottom right of the FLC. 1.2 Emergency Stop Activating the Stop button (in an emergency) All system movements and release of radiation is disabled. Turning clockwise (when situation has been rectified) Turn Emergency Stop button clockwise and release. System movements and release of radiation are now enabled. 5 Turnover Workbook | Luminos Agile Max - VE10 and Higher 2. Hardware Features 2.1 Detectors Notes (3) (1) (2) (1) Detector MAX wi-D, to be used in table and wall stand and for free exposure (2) Detector MAX mini, for free exposures only (3) Detector indicators *Note: Detector calibration should only be done by a trained facility service engineer. LEDs are provided on the detector (close to the handle), to give basic information on the detector behavior. Detector Indicators (5) (4) C (1) (2) (3) (1) Detector status LED (2) Wi-Fi status LED (3) Battery status LED (4) Infrared sensor needed for attachment of a detector (MAX swap (5) Power button Long push (switch off/on) 6 Turnover Workbook | Luminos Agile Max - VE10 and Higher Detector Battery Notes Charging the battery of the detector can be accomplished: with the detector in the closed table bucky tray (MAX Wi-D only). • with the detector in the closed wallstand bucky tray (MAX Wi-D only). • in the battery charger. • uGym2 MAX dynamic MAX WI-D Serial number 134602 clibration due 27-04-2016 28-04-2016 Walistand V Table Free Detoutfor re Disconnect OK Cancel forgan program | 1/21 Changing the Batteries The battery is located on the back of the MAX Wi-D and MAX Mini. Changing the battery is a 3 step process. It is recommended to power down the detector prior to removing the battery. 1. Locate the battery on the back of the detector 2. Turn the lock on the handle to the Unlock position 7 Turnover Workbook | Luminos Agile Max - VE10 and Higher 3. Lift the battery and remove it Notes To insert a battery, insert the battery and turn the handle to the Lock position, then press the handle down. The Battery Charger In order to charge the battery, when inserting a battery in the charger (if present), ensure that the gray stripe on the battery is facing the triangle on the charger. Standard with the MAX Mini; optional with the MAX Wi-D • Charging time is approximately 4 hours in the battery charger • 4 LED’s will indicate the amount of charge on the battery • Note: It is recommended to turn the detector off before removing the battery. 0-25% 25-50% 50-75% 75-100% 100% 8 Turnover Workbook | Luminos Agile Max - VE10 and Higher Notes Grids 1. Clip-on grids for MAX Wi-D will have either a 5:1 or a 15:1 grid ratio. Both will have a focus of 45 inches. 2. Clip on grids for MAX Mini will have a 5:1 grid ratio, with a focus of 45 inches. Attaching/Removing the grids 1. Insert the detector into the slot on the back of the grid, with the front of the detector facing the same direction as the front of the grid. 2. Push the detector down against the loading springs until the detector is secured inside the frame of the grid. 00 000 0 00 3. Ensure that the LED lights show through the LED openings on the grid. 4. To remove the grid, press the detector down against the loading springs of the grid and pull the detector out. 000 0 (4) 9 Turnover Workbook | Luminos Agile Max - VE10 and Higher 2.2 Patient Table with Wireless Mobile Detector Notes Weight Limits • 275 kg (606 lbs) only table lift possible - Up to 230 kg (507 lbs), table tilt, table lift, and footboard use is possible (no table - top movement) Up to 182 kg (400 lbs), all table movements possible - Accessories • Grid insertion/removal • For pediatric exposures, the grid can be removed - Stationary; 15/80 focused at 115cm - Bucky Tray • Lumin When the tracking function is active, the detector tray follows the longitudinal - movement of the 3D overhead tube. The table bucky tray can be moved manually by pulling out the gray handle and - moving tray into position It can be aligned automatically to the position of the overhead tube by pressing - and holding the tube/detector centering button (See Table side functions) 10 Turnover Workbook | Luminos Agile Max - VE10 and Higher Tableside Functions Notes • -88 Note: All of these functions are allowed only while the button is being pressed. Releasing the button stops the function. P Activate Parking of Digital Imaging Tower (DIT) PS Activate Unparking of the DIT Note: See steps to Park and Unpark the DIT on p.12 Patient Transfer Upright – Patient Transfer Vertical 53. Patient Transfer Down – Patient Transfer Horizontal -88 Tilt Degree – Table Tilt Angle Tilt – Table Tilt (Table will stop at 0 degrees unless Table Tilt Override is activated. See DIT Control Panel Functions p.15) Park Override – Overhead Tube Park Override V Tube-Detector Centering – Tube/detector centering Raising Lowering Table – Table height adjustment. Note: Table will move lowest when the DIT is parked Table movements – Table top movements. Table will stop when it gets centered either transverse or longitudinal. 11 Turnover Workbook | Luminos Agile Max - VE10 and Higher 2.3 Parking and Unparking the Digital Imaging Tower (DIT) Notes Parking Parking the DIT using the motorized function is a 4-step process: P 1. To begin, press P, either tableside or on the DIT. 2. Vertical Lock - Move the DIT vertically until the Vertical Lock light displays. 3. Transverse-Longitudinal Lock - Move the DIT transversely until the Transverse/Longitudinal Lock light displays. 4. Park - Press and hold P at the tableside or on the DIT until the DIT is P parked. Unparking Unparking the DIT is a motorized function as well. Press and hold Unpark from the tableside or the DIT until the DIT unparks. Note: All system motorized movements are dead man functions. This means that the movement will only occur as long as the operator is pressing the button for that function. 12 Turnover Workbook | Luminos Agile Max - VE10 and Higher Manual Release of the DIT Parking Brake Notes Use for immediate movement of the DIT in emergency situations. 1. Locate Parking Brake lever on the back of the DIT O ... 2. Pull lever to the right and hold 3. DIT can then be manually moved in or out. 13 Turnover Workbook | Luminos Agile Max - VE10 and Higher 2.4 Digital Imaging Tower (DIT) Notes The Opti-Grip Note: The Opti-Grip has a dead man grip. When gripped, 2 LED’s will light up and the DIT can be moved. Opti-Grip Functions • Exposure Release (Configurable, may be found on the front or back of the Opti-Grip 00000 Motorized Collimator Adjustment (Pressing the center button will open 000 collimation to its full field) DO # O Fluoro Release button (Configurable, may be found on the front or back of the Opti-Grip) Motorized Table Tilt (There are two speeds when using the tilt function on the Opti-grip. Pressing down half way will tilt the table 3 degrees per second. Pressing all the way down will tilt the table 6 degrees per second.) Motorized Tabletop Movement 900 14 Turnover Workbook | Luminos Agile Max - VE10 and Higher DIT Control Panel Functions Notes The two touch panels on the DIT are identical to each other. O P P Park motorized control for DIT Unpark motorized control for DIT Note: See 2.3 for instructions on Parking and Unparking the DIT *Compression Cone in/out (*Purchasable option) Vertical/Compression Lock: Activates/deactivates DIT vertical brake/ compression lock Transverse and Longitudinal Lock: Activates/deactivates DIT transverse and longitudinal lock Center Lock: Activates/deactivates centering of the DIT. Pull or push DIT toward or away from you until light comes on. Once locked, the DIT can be moved in a single plane head to foot. Table Tilt Override: when active, the vertical lock will engage and the table will not stop at 0° when tilting up and down. 15 Turnover Workbook | Luminos Agile Max - VE10 and Higher Park Override: When the overhead tube is not in the park position, Notes pressing and holding this button will allow movement of table and DIT Switches on/off room lights (if configured) and DVD recorder (if purchased and configured) Fluoro Timer Reset: will activate after 5 minutes of active fluoro time Fluoro Zoom Formats (Zoom 1, 2, 3 and Full Field) Zoom 1 – 11.8in x 11.8in • Zoom 2 – 8.7in x 8.7in • Zoom 3 – 5.9in x 5.9 in • Full Field – 16.8in x 16.8in • O Toggle between single image and series acquisition. LED off: single images, LED on: Series Series Replay: Starts/stops loop Increase or decrease pulse rate + Store Image: Store a LIH (Last Image Hold), a new image, or a modified image *Store Fluoro Loop (*purchasable option): Stores dynamic loops of fluoro. Length of loop stored dependent on pulsed fluoro used. PO 16 Turnover Workbook | Luminos Agile Max - VE10 and Higher Notes Acquisition frame rate reduction (primarily used with *DSA, *purchasable option) Other DIT Information Lead Shielding/Counter-weights: The lead shield is one piece. Pull to unlatch and remove. To attach, slide into place until you feel it latch. Store the lead shield on the wall-mounted unit when not in use. The counter-weights are to be used if the lead shielding is removed. Place both counter weights in the top right side of the DIT behind the control panel. Store the counter-weights in the wall mounted unit when not in use. Collision Protection: Electronic safety switches are located on both sides of the DIT. They stop the movement of the DIT when they are pressed. To deactivate the switches, move the DIT slowly in the opposite direction 2.5 Touch User Interface (TUI) The TUI is separated in three sections. The left hand side will show fluoro parameters; the center section shows the acqistion/radiographic parameters; and the right hand side is for image review and setup. 8 0 cm II #42.0x42.0cm 01 AllModes DFR Single Shot Image Tools Setup + 0 0.2 70 KV mm Cu ky 0.0 30 MA p/s 88885 0:00 15 REF min p/s T ? Ready Note: Not all icons may be displayed on the TUI as some are optional 17 Turnover Workbook | Luminos Agile Max - VE10 and Higher Notes Fluoro Parameters The fluoroscopic data of KV, mA, and time in minutes are displayed on the left hand side of the TUI. Fluoro Curve 1, 2, or 3 Regulation Stop: Switch on/off regulation stop. When activated the kV and mA values are kept at the current level independent of object thickness. Fluoroscopy timer alarm reset *Store Fluoro: Stores the most current loop of fluoro. Length of loop depends on the pulsed fluoro used (*purchasable option) 0.2 Copper Filtration mm Cu 30 30 pulses per second: High speed fluoro only available with Zoom 2 or full p/s field 15 CARE Vision (Pulsed Fluoro): Pulse rates are 15, 10, 7.5, and 3 pulses per p/s second. Acquisition Parameters Measuring Field(s) (dominant) 4 f/s Frame Rate (.5, 1, 2, 4, and 8 frames per second can be configured) Toggle between single image and series acquisition Restore original values 18 Turnover Workbook | Luminos Agile Max - VE10 and Higher Image Review and Setup Notes Image Subtask Card • Show the previous image (of a series) Show the next image (of a series) + Show the previous series Show the next series Replay series: start/stop loop Store the current image, Last Image Hold (LIH) Toggle between study or series overview and fullscreen display Tools Subtask Card • Mark or unmark a single image for sending 000 000 Preselect L or R label to be placed on image Lock Collimation: the last collimation set in the organ program is locked # and will be used for all the next organ programs. 19 Turnover Workbook | Luminos Agile Max - VE10 and Higher Setup Subtask Card Notes • Orientation of image from top to bottom – for patients who are feet first on the table 70 R Orientation of image from left to right – for patients who are prone on the table Reverse tabletop movement. This applies to movement from the Opti-Grip Disable system movement. Disables all movement of the table, DIT, KZ overhead tube (if present), and wall stand (if present) Disable radiation. Prevents the release of both fluoro and radiographic radiation from both the under-table tube and the overhead tube (if present) DVD *DVD Recording. Records live fluoro loops on the fly (*purchasable option) G *CAREPosition on/off. Radiation free positioning of the patient (*purchasable option) Header • The Header of the TUI will display the following: SID - Table Tilt - Park status - Grid in/out - Collimated field size - Movement disabled - Radiation disabled - Footer • The Footer of the TUI will display the following: Help on/off - System messages - Zoom selection - 20 Turnover Workbook | Luminos Agile Max - VE10 and Higher 2.6 3D Tube with MaxTouch Display Notes Movement Buttons There are eight buttons for movement on the MaxTouch that are associated with colored arrows. The buttons by the blue arrows will unlock up and/or down movement of the • overhead tube. The buttons by the orange and green arrows will allow movement of the overhead • tube along the associated tracks on the ceiling. The buttons near the purple arrow will allow rotatation of the overhead tube along • the vertical axis. The button near the pink arrow will allow rotation of the overhead tube along the • horizontal axis. The button near the overlapping blue, orange and green arrows will allow • movement of the overhead tube in all three directions (as will the buttons on the end of each handle). Tape 90 Device Measure Position KV MAS Generator 2.5 0 Setup Dose S O mm Cu ? APPS, SIEMENS BBBBB T CHEST AP T i Select mAs value or set ACSS A 32.1" 8 # 45.3" - + 16.2" + Manual = 13.7 " = 21 Turnover Workbook | Luminos Agile Max - VE10 and Higher Tab Cards Notes Generator • kV and mAs - used to change technique 73 KV - mAs Exposure Correction - used to increase or decrease 0 - exposure points (-2 to +2) Dominants - used to change which AEC chambers - are active. Tape Measure • Tape Measure DO 8 Generator 0 cm 0 cm DO DO SID measurement - SOD measurement - Magnification display (SOD Mag = SID/SOD) - Can be displayed in inches - 22 Turnover Workbook | Luminos Agile Max - VE10 and Higher Device Position Notes • y* Device Position Setup 00 -16º Tube Angulation - MAX Align - Setup • Device Position Setup Block Radiation - Block Movement - Tube Speed - 23 Turnover Workbook | Luminos Agile Max - VE10 and Higher Information Display Notes The section at the bottom of the MaxTouch displays information such as collimation size and detector orientation. Directly accessible functions Restore Collimation – recalls last collimation from previous exposure. • # Cleaning the MaxTouch Do not spray the MaxTouch directly. Wipe the MaxTouch only with a clean, damp cloth. 2.7 Wall Stand System movements • Grid insertion/removal • 115, 140 and 180cm focused grids - 300 cm grid is for Ortho package only* (purchasable option) - 24 Turnover Workbook | Luminos Agile Max - VE10 and Higher 3. FLC and Performing Patient Exams 3.1 General Workflow Notes High level overview There are four main steps to the workflow: Patient Task Card • Register a patient - Examination Task Card • Examine the patient - Postprocessing Task Card • Manipulate an image - Documentation Task Card • Archive the exam/studie - 3.2 Overview On the Fluorospot Compact (FLC), the main area of the monitor shows: 1. Preregistered Patients List of patients from RIS or patients that have been manually entered • 2. Examined Patients List of patients that have been examined. This is where you can burn a CD/DVD • 3. Archiving Information This screen is always blank and will never contain patient information. • . 3.3 Patient Tab Patient Patient Subtask Card Patient Settings Service + RIS RIS 25 Turnover Workbook | Luminos Agile Max - VE10 and Higher Registering a Patient Notes To select a patient from the Preregistered list: 1. Click on the Patient tab. RIS 2. If your system has a RIS, click on the RIS icon to update. OR Click on this icon to do a patient search. RIS 3. Double click on the patient’s name to be examined or highlight the patient’s name and click on the Examination Tab. To manually register a patient: 1. Click on the Patient Tab. 2. Click on the Patient Registration icon (Create New Study). 3. Populate all fields in bold text. 4. If this is a patient with no data, click on the Emergency icon to start the examina- tion. You will be able to populate the data later. Settings Subtask Card Patient Settings Service . EXI User Settings • View Job Status • PEX Editor • Clinical EXI Log • Recycle Bin (if configured) • 26 Turnover Workbook | Luminos Agile Max - VE10 and Higher Service Subtask Card Notes Patient Settings Service Service Login • Remote Desktop Assistance • Rejected Images • Statistics • Exporting Data via USB You may export log files using a USB memory stick. 1. Clinical EXI Log 2. Reject Analysis Log Exporting Data via CD/DVD You may export patient studies/images via a CD/ DVD using the Examined Patients Task Card. Open the Examined Patients Tab Card. • Highlight study to be exported. • Choose Export icon. • Choose CD/DVD from Mode • Select other options as necessary. • 27 Turnover Workbook | Luminos Agile Max - VE10 and Higher 3.4 Exam Tab Notes Examination Patient Resource Information The patient loads with all of the OGP’s for the exams ordered. If you can not see the entire list, click on the eyeglasses icon to expand the list. NOTE: Right-clicking on the OGP will show you a summary of the OGP set up in the PEX editor. Joe, Don 123456 0 0 X ANKLE AP Left X ANKLE LAT Left C CASSETTE Fluoro Rad Acquisition Parameters All Organ Programs will populate with predefined acquisition parameters. 258.0 " x 258.0 " These are based on an average adult patient and should be Current Target none 45.3 " adjusted for body habitus and pediatric patients. *AEC Exposure: Sensitivity 400 = Detector Dose 2.5μgy KV 70 mAs Dose 2.50 S 0.0 mm C 0.0 Focus % 80 28 Turnover Workbook | Luminos Agile Max - VE10 and Higher Fluoro Parameters Notes D32_m10_70kV Series Native p/s 15 8 KV 0 KV 70 MA 0.0 MAS ms 0.0 ms 0:00 Dose 0.28 min 0.0 mm Cu 0.2 mm Cu 0.1 30 p/s Focus mGy/min % < 2 Gy 0.0 nGy 0.5 All Organ Programs will populate with predefined fluoro and acquisition parameters. If necessary, changes to the pulse rate, for fluoro, can be made here or at the TUI. Likewise, for acquisitions, changes to the frame rate can be made here or at the TUI. Fluoro time in minutes can be found here or on the TUI as long as you remain in the current study. Once exiting the study, fluoro time can be found on the exam protocol. The Exam Protocol can be found under the Tools Subtask Card in Examination or Documentation. Once selected the following information will display. Fluoro time and the Dose Area Product can be found in the upper right corner. Patient Name Test, Patient Number of seriesimages 1/ 19 Date of Birth: 01-06-1962 Request D Fluoro time gran | 0:00 Patorg D 150311 082707 Accession No Doce Area Prod Sax M Study Descr. 1 All Acq Types Accumulaled Values Ward Pert Physician Ficoro time on | 0:49 Institution Namo Dose Area Prod : 55 41 Entrance Dose (Gy, 0.50 Image No | KV | mk3 | my Doge Scere le. C Eter | For Back Cher C. Dste and Ti |Organ program LIH 1 56 Cu02 426 18-03-2011 .. : D32_10_70KW 53 098 0.1 0.3 0 278 CuO.1 RAD 11/80 18-09-2011_ RAD Fre Exp C Cu01 42.6 O 18-03-2011. 1_Series Bts [1 Put onAimeheet Print Close The Exam Protocol can be configured in the User Settings to be sent to PACS as SC Image (secondary capture image) or as a DICOM Dose SR (structured report). 29 Turnover Workbook | Luminos Agile Max - VE10 and Higher Exam Manager Notes If the Exam Manager is displayed, you will need to select the correct exam on the left side, click Replace in the center so the accession number stays the same, and click Examination. The Exam Manager is displayed whenever the exam name from the RIS is not recognized by the PEX Editor, or that exam name has not yet been programmed. This may also be used to add views not displayed in the list of protocols. This happens because the Exam Name from the RIS does not match what you have entered into the PEX Editor. Remember to correct the exam spelling in the PEX Editor. The triangle will appear when there is a RIS Mismatch. To fix this, refer to the section on “Entering Exam Names” in the PEX Editor section. Patent Test Testing ₲ OrgmePragure by Exam C offiebele by bedypor login JWLTHp wowDowns Esophog ms 2pt.BW Accunice Number 13214 Image Subtask Card Image Tools Cropping Tool • Store Image • Navigation Buttons for Image Review • Send Image” • You are able to crop your image and review all images. Tools Subtask Card Store/Review Reference Images • Review Exam Protocol • NOTE: Monitor Display The information that populates in the four corners is configurable. The upper left side should show a white circle, meaning that the image is marked to be sent to the printer or PACS. The bottom left corner shows the Clinical EXI. This number has a low and high range and is only one of the determining factors for checking if the image is under/ overexposed. 30 Turnover Workbook | Luminos Agile Max - VE10 and Higher 3.5 Postprocessing Tab Notes Postprocessing The Postprocessing task card lets you make changes to the acquired image. It is divided into three subtask cards: 1. Process 2. Graphics 3. Rad Process Subtask Card Process. Graphics Rad Zoom/Unzoom image 1:1 pixel display • Invert grey scale • ~1:1 Flip image horizontal and vertical • R Window – Contrast and Brightness adjustment • 5 70 Window Center = Brightness (move mouse up/ - down) Window Width = Contrast (move mouse left/right) - Rotate image • Process. Graphics Rad Several rotational functions are available. Click - icon for the options. Images can be rotated by simply left clicking on the - image and, holding the left mouse button down, R rotate the image to the desired level. RD R -R R PR 31 Turnover Workbook | Luminos Agile Max - VE10 and Higher Notes Process. Graphics Rad Graphics Subtask Card Set laterality label (R/L marker) • 9,90 Draw arrow • Draw distance/calibrate 5 • Remember to store the image with the distance - XYZ graphics as a new image. The graphics are “burned into” the image Draw angle • Enter text • Text can be placed anywhere in the image - You can build a list for text and comments and change the text size - Rad Subtask Card Process. Graphics Rad Auto-cropping Set black Auto-window Amplification 2.0 ¥ Auto as cropped Cropping Tool – Will open to raw image and show collimation lines. Using your mouse, you can: Drag lines in, out, up. and down . • Drag the corners to new positions. • Left click and hold to draw your own new box. • Right click and release (four times) to create your own four input points. • Click on the button with the blue check mark to accept changes. • Amplification Tool - Used to adjust the contrast of the image Use the drop down box to select a new value • Higher numbers are darker, lower numbers are lighter • 32 Turnover Workbook | Luminos Agile Max - VE10 and Higher If there is a check mark in the “Auto” box, click on it to remove it so that you can get Notes • the drop down box Click on the button with the blue check mark to accept changes” • V Note: The Rad Subtab will not be present on fluoro images. • 3.6 Documentation Tab Documentation The Documentation task card is where you archive patient studies. It is divided into three subtask cards: 1. Select 2. Film 3. Send Select Subtask Card All images need to be marked with a Select Film Send white circle to be sent to the hardcopy camera or PACS. Mark all images • Unmark all images • Mark/unmark single image RAD • Delete images • Film Subtask Card Select Film Send The Film subtask card can be set up with a default Printer DICMPrinter hardcopy camera and film size and layout per exam. dicom, TEST 14INx17IN. 1×2. 100% Film marked images • Name | TEST Preview marked images Size 14INx17IN • Show film status Layout 1×2 • O Auto Scale 100% 100 Print as substracted Override configured settings Copies 1 : Anonymous Hide Text 33 Turnover Workbook | Luminos Agile Max - VE10 and Higher Selec Film Notes Send Send Subtask Card The Send subtask card can be set up with three default Target 1 *PACS networks/PACS. Target 2 Test Send marked images • Target 3 Show send status • Send exam protocol to the network as a Secondary Send Exam Protocol as: • Capture image MSCimage DICOM Dose SR Send a DICOM Dose Structured Report to the network • Override the configured settings for the Send targets • Override configured settings 34 Turnover Workbook | Luminos Agile Max - VE10 and Higher 4. PEX Editor 4.1 PEX Editor Overview Notes Programs and Exams Editor is divided into five task cards: Exam • Enter your RIS exam names and OGP views - Organ Program • Edit technical factors - Fluoro Program (no function on this system) • Param. Module • Build Stand Positions* - Configuration • Backup system - *Fully automated system only 4.2 Opening PEX Editor On the Patient Task Card > Settings Subtask Card click on this icon. The login screen will appear. Click the radio button next to Siemens • Enter the password that your Clinical Education Specialist gave you and click OK • Programs and Exams Editor -- a Cutcurar 35 Turnover Workbook | Luminos Agile Max - VE10 and Higher 4.3 Exam Tab Notes The PEX Editor opens up to the Exam subtask card. PEX Editor Exam Organ program Fluoro program Film Layout Param. Module Configuration OGP View Examination View MM ...... 9_Cassette_Template (d) + TOES-RIGHT 9_Peri_Template (d) + -- M UGI STUDY M 9_Scan_Template (d) Insert OGP + UPPER EXT. INFANT MIN 2V BILAT(d) 9 Tomo_Template (d) UPPER EXT. INFANT MIN 2V LEFT(d) M C Abdomen, left side pos. (d) M UPPER EXT. INFANT MIN 2V RIGHT(d) C C-spine lat (d) You can also M VOIDING CYSTO-URETHROGRAM C Cassette (d) drag&drop OGPs from + ... WRIST 4 VIEW-BILATERAL C Femural neck axial (d) the OGP view to Exams + M WRIST 4 VIEWS-LEFT C Hip (d) in the Examination view WRIST 4 VIEWS-RIGHT C Hip, with grid (d) + ... WRIST ARTHROGRAM MC Humerus lat (d) + - Remove OGP M WRIST-BILATERAL C Patella tangential (d) + - WRIST-LEFT C Pelvis (d) WRIST-RIGHT ~ Dolvic with grid(r) XR Nasal Bones(d) Group by Name Body Part Acq type Sort by @ Name Body Part Acq. type Exam parameters Default Exams OGP Parameters ExamName XR Nasal Bones Name for RIS XR Nasal Bones Add to favorites Filming Layout Network Node 1 Default Network Node Exam Level OGP Level Network Node 2 Fluoro Network Node 3 Rad Camera Default camera O Auto Scale @ Auto Scale % % o Automatically switch to next OGP after acquisition Store as new Store Exam Delete Entering Exam Names On the right side of the screen you see Examination View. This is where you will modify or create the listed exam names to match your site’s RIS Exam Names. (You will need to have a copy of your RIS Examination Names.) 1. Left click on an Exam name that closely matches one of your exams. 2. Populate the Name for RIS and Exam Name fields with the correct name. 3. When finished click Store if you modified the name or click Store as New if youcre- ated a new name. 4. Continue until all exams are entered. NOTE: It is very important that you type in the name exactly as it appears on your list (word-for-word and spacing). If not, the study will not populate when you click on the patient to be examined. 36 Turnover Workbook | Luminos Agile Max - VE10 and Higher Adding/Removing OGP View in Examination View Notes 1. Examination Views can be customized with the views needed. The order of the views can also be customized. 2. Select the Examination View to be modified. Open the drop down box by double left clicking on it or clicking on the Plus Icon. 3. To add a new OGP view, find the correct one under the OGP View on the left side. Click on it one time and select the Insert OGP button in the center. (Be careful to choose the correct acquisition mode - T, W, X.). 4. To remove an OGP view from the Examination, click one time and click the Remove OGP button in the center.” Exam Organ Program Fluoro Program Param. Module Configuration OGP View Examination View T ABDOMEN SUPINE (d) 0 Pex Database_VE10_Sept2014_Mas T ABDOMEN SUPINE Casette (d) 0_RAD_Daily_Check(d) T ABDOMEN UPRIGHT (d) 0 Siemens CSE Test Programs(d) T AC JOINTS (d) 1_Position_Setup T ANKLE 0-3yrs (d) Insert OGP ABDOMEN 3 VIEWS_S(d) T ANKLE 4-12yrs (d) T ANKLE AP (d) W ABDOMEN UPRIGHT (d) T ANKLE AP Left (d) W ABDOMEN DECUB (d) T ANKLE AP Right (d) T ABDOMEN 0-3yrs (8-14cm) (d) T ANKLE BILATERAL (d) W ABDOMEN 4-12yrs (12-20cm) (d) T ANKLE LAT (d) W ABDOMEN 12-16yrs (14-22cm) (d) T ANKLE LAT Left (d) T ANKLE LAT Right (d) Remove OGP C CASSETTE (d) FM ABDOMEN FLAT & UPRIGHT_S(d) T ANKLE Left 0-3yrs (d) ABDOMEN UPRIGHT VIEW ONLY_S(d) T ANKLE Left 4-12yrs (d) ABDOMEN-ACUTE INCL PA CHEST_S( ................ Group by O Name Body Part Acq. type Sort by @ Name Body Part Acq. type You are able to arrange the order of the views by clicking on the arrow. V ABDOMEN 3 VIEWS_S(d) T ABDOMEN SUPINE (d) ABDOMEN UPRIGHT (d) W ABDOMEN DECUB (d) T ABDOMEN 0-3yrs (8-14cm) (d) W ABDOMEN 4-12yrs (12-20cm) (d) W ABDOMEN 12-16yrs (14-22cm) (d) AABMARTIN SUL Checking the box Automatically switch to next OGP after acquisition allows the next view to populate during the exam. Make sure to click Store to save. - Automatically switch to next OGP after acquisition 37 Turnover Workbook | Luminos Agile Max - VE10 and Higher 4.4 Organ Program Tab Notes This tab shows the technical factors for the OGP views - to include AEC chambers to be activated, technique, collimation size, etc. It is used to modify or create an OGP View.’dThis tab is opened by selecting an OGP view in the Exam Tab and then selecting the Organ Program tab, or double left clicking on the OGP View. Modifying or Creating OGP View Begin by going to the correct acquisition mode in the Exam tab. C = Cassette exposure • T = Table exposure • W = Wall exposure • X = Free exposure • 1. Choose the OGP view to be modified, or (for a new OGP) a view that is similar to the one to be created. 2. Select the Organ Program tab or double left Exam Organ program click on the OGP view. Body Part Examined LSPINE Program Name T L-Spine a.p. (d) 3. For a new OGP View, change the name in the Acquisition Mode DR RAD Program Name box. Be sure to delete the (d) at Acquisition Type Table the end, but do not remove the acquisiton mode (T, W, X). To modify the view, you will not make any changes to this box. 4. Make any technical factor changes to the view parameters, such as technique and collimation size. 5. For a new OGP view, select the Store as New button at the bottom. For a modified view, select the Store button. x - Ray Parameters Presettings Mark Image PT Position Not defined Fluoro Program Set none Laterality Not Defined MField View position Not Defined Anatomically Correct View 1 pt Flip No change 1 pt with ext. exp. 2 pt 3 pt 3 pt with AEC Rotate 90 @ 180 2 KV 81 Label mAS ms Exp. Correction OEP Dose 2.54 Stand Parameters Sensitivity 400 TOD not defined cm Tube Load 80 Grid 115 cm Grid rotation % Collimator 16.93 X 16.93 inches Focus Filter Type 0.0 Stand Position W 45 NO angle MID - Cumm Top Alignment SID Tracking Tracking Store Store as new 38 Turnover Workbook | Luminos Agile Max - VE10 and Higher 4.5 Param Module Tab Notes This tab is used to create stand positions on fully automated systems (optional). rogram Param. Module Configuration Stand Position Identifier d008 Name W 45 NO angle HIGH Collimator settings Ignore for auto-cropping Position: Undefined Store Position Store Parameters Delete Activate New 4.6 Configuration Tab This tab can be used to change the default password, make a backup of the database, and to import a database. gram Param. Module Configuration Password Change Password Reset Customer Password Database Export/Import Backup / Export Restore / Import Merge Include RIS Names ... 39 Turnover Workbook | Luminos Agile Max - VE10 and Higher Backup PEX Editor Notes After you finish making changes in the PEX Editor, it is very important to do a backup. 1. Click on Configuration. 2. Click on Backup/Export 3. Click on C Drive and click GO Then do the same for the D Drive. Import PEX Editor NOTE: Each import replaces the current database and cannot be undone unless database has been backed up so be careful not to replace the original or most recent backup. Consider making a backup of current database before importing a new one. On the local hard disk (e.g. drive C: and D:) the number of backups is limited to 10. For more details and diagrams of the PEX Editor, please see the online User Manual located by pressing the F1 key on the keyboard while on the Patient tab on your Fluorospot Compact. 40 Turnover Workbook | Luminos Agile Max - VE10 and Higher 5. User Settings 5.1 Overview Notes User Settings are customizable settings that include sending of dose reports, modifying auto delete of old exams, and turning on/off reject analysis. To get to the User Settings, in the Patient Tab, select the Settings subtab. Choose the Wrench Icon on the top left.. USER SETTINGS X DICOM Image Display Examination Site Info Exam Properties and Print Pr ... Properties Manage ... ww - Image Delete Acquisition Patient Order Registrati ... 5.2 DICOM Properties In the Sending tab of the DICOM Properties, it is possible to select rather or not to auto send the dose report as well as the background color of the dose report. Background Color of Exam Protocol Notes It is possible to send the Exam Protocol (exposure data, fluoro time, number of images, etc.) over the network with the patient images. These are sent as an SC, or secondary capture image. The background color of this SC image can be selected as black or white. DICOM Properties X General Protocol codes Sending Printing Store Storage Commitment Waiting time hours Number of retries 2 Worklist query RIS Timer 0 min Modalities to query > CR DX RF Other Modality Performed Procedure Step I -rottePe srersanas Study Complete Method Mark Order Acquisition date and time Anatomic order number EXI value for DICOM Physical Clinices OK Cancel 41 Turnover Workbook | Luminos Agile Max - VE10 and Higher 5.3 Site Info Notes This tab allows for input of Institution name, screen saver wait time, and patient demographics to be displayed for each exam. Site Inda X Institution Name YSio Institutional Department Name Cary, NO Screen saver Wait Time min Patient Demographic Data Accession No Request ID Patient ID Date of birth Patient list @ Single study mode Multi study mode Display image receptor size in cm inch Daylight saving time Automatic activation OK Apply Cancel 5.4 Image Delete and User Initials Notes User initials can be part of the DICOM header with the images or for Reject Analysis User Settings • Auto Delete • User Initials – enter user initials in the dialog box when a patient is registered • Use as DICOM operator name – user initials will be inserted into DICOM header • Image Delete X Auto delete > Enable auto delete Hard disc fil level 604% Deletion size 4046 Activation time 20:13:40 Activation date . Daily Week Conditions ~ Images sent Images filmed Images stored on CD/DVD User confirmation Archiving information Maintain deleted studies Recycle Bin Enable Jser initials Use user initials use as DICOM operators name Rejected Images Analysis Enable rejected images analysis F Provide user related analysis Password Change Password protected OK Apply Cancel 42 Turnover Workbook | Luminos Agile Max - VE10 and Higher 6. MAX Swap 6.1 Attaching and Detaching Detectors Notes Detaching a Detector To detach or disconnect the MAX Wi-D or MAX Mini from the system, click on the Detector Overview icon to open the Detector Overview information window. Detector overview X Portable Default Type for Free Exposures uGy'm Patient MAX mini e4x 30 cm MAX wi-D 43 x 35 cm MAX wi-D Detector Type 43 x 35 cm MAX mini 24 x 30 cm Examination Postprocessing Documentation Serial number S/N:182612 S/N:182922 Patient Settings |Service Battery - Signal Actual Position RIS Free Table Disconnect Disconnect Calibration due 18-09.2020 8-09-2020 Firmware Up-to-date Up-to-date Fixed Detector Type MAX static Calibration due 17-09-2020 Position Wallstan FARE Close Select patient 0%HU Select the wireless detector you wish to detach, then click on Disconnect. Confirm that you want to detach this detector, and the detector is now detached from this system. NOTE: If the detector is just removed from the room and not detached, it may cause problems with performance and workflow with the system. 43 Turnover Workbook | Luminos Agile Max - VE10 and Higher Attaching a Detector Notes For a detector to be attached, or connected, to the Luminos Agile MAX, the system must first know the serial number of the detector and it’s calibration data. To do this, follow these steps: 1. Locate the infrared sensor on the front of the Fluorospot Compact. It is located in the upper right hand corner. 2. Make sure the Fluorospot Compact is in the Patient tab. Then click on detector overview. 3. Hold the wireless detector you wish to attach in front of the infrared sensor. This should be done along the edge of the detector, between the indicator lights for the wireless network and the detector status. 4. Confirm the message on the Fluorospot Compact about the attachment. 5. This detector is now attached to the system. SIEMENS ....... 44 Turnover Workbook | Luminos Agile Max - VE10 and Higher 6.2 Switching Between MAX Wi-D and MAX Mini Notes It is possible to exchange the MAXWi-D and MAXMini between systems. 1. On the Max Touch – Look for a new button in the lower right hand corner to select which detector you wish to use. + 2. On the Fluorospot Compact – Click on the detector you wish to use. Select the portable detector to use for free acquisition Detector 1339D1 Detector 133908 NOTE: If both the Max Wi-D and the Max Mini are attached and ready for use, select the appropriate detector for use or put the Wi-D in the table or wall bucky. In the Patient tab of the Fluorospot Compact, in the lower right hand corner, is the detector overview icon. Click on it and you will see the detector overview screen. This will show you what detectors are currently connected to the system, what the serial number is (MAX Wi-D and MAX Mini) and the latest calibration data. 45 Turnover Workbook | Luminos Agile Max - VE10 and Higher 7. Quick Info 7.1 Abbreviations Notes FLC - Fluorospot Compact, the operating system FD - Flat Detector BWS - Bucky Wall Stand Wi-D - Wireless detector OGP - Organ Program, a set of parameters for acquisition T - Table Bucky Acquisition W - Wall Bucky Acquisition X - Tabletop or Free Exposure 7.2 Status Messages and Display Ready OuDr. 5 + 2% hu Symbol Short description Ready for acquisition Not ready Free hard disk space 100% 0% OUD OUD OUD Free DVD space 100% 0% Detector temperature is not within required range. Detector calibration has expired. 46 Turnover Workbook | Luminos Agile Max - VE10 and Higher 7.3 Cleaning Notes The following substance classes may be utilized for the entire system excluding the monitors and touchscreens. Aldehyds • Alkylamines • Quaterny Compounds • Guanidine Derivates • Peroxide Compunds • Pyridine Derivatives • Organic Acid • Chlorine Derivatives • Household Detergents • Please keep in mind substances with Quaterny Compounds and Chlorine Derivatives must not be used on stainless steel surfaces. Cleaning and disinfecting the monitors and touchscreens please note: The following substance classes are recommended: • Aldehydes - Chlorine Derivatives - Alcohol - The following substance classes must not be used: • Peroxide Compounds - Gasoline - Regarding the disinfecting “effect” of the substance classes, please note: The following substance classes have no disinfecting “effect” and are only cleaning • substances: Household Detergent - The following substance classes have disinfecting “effects”, but cannot be used for all germs. The knowledge regarding the effect for specific germs must come from the hygiene officer from the site/hospital. Aldehydes • Alkylamines • Quaterny Compounds • Peroxide Compounds • Pyridine Derivatives • Organic Acid • Chlorine Derivatives • Alcohol • 47 Turnover Workbook | Luminos Agile Max - VE10 and Higher 7.4 Technical Data Notes Patient table Max. patient weight 275 kg or 606 lbs • Table grid Stationary; 15/80; focused grid: 115 cm • Wall stand Detector Tiltable from – 20° to + 90° with 0° detent • MAX Wi-D Detector (Optional) Dimensions (Active Area) 34.9 x 42.5 cm • Active area matrix 2356 x 2872 pixels • Pixel size 148 microns • Scintillator Cesium Iodide • Acquisition depth 16 bits • DQE in %, 2 μGy (RQA5) 66% at 0.05 lp/mm • Data transmission < 2 sec. preview, <5 sec. full image • Thickness 19 mm • Weight 3 kg • Max. load capacity 150 kg with patient recumbent • 100 kg with patient standing Battery Lithium ion, rechargeable, exchangeable • Charging time 3 hours in battery charger • Battery operation time Up to 525 images • Up to 3.5 hours during normal use Up to 6 hours in standby mode Charging location Table detector tray, wallstand detector tray, • battery charger Clip-on grids (optional) 5:1, 85 lines/cm, 115 cm focus; 15:1, 80 lines/ • cm, 115 cm focus 48 Turnover Workbook | Luminos Agile Max - VE10 and Higher MAX Mini (Optional) Notes Dimensions (Active Area) 28.4 x 22.8 cm • Active area matrix 1538 x 1920 pixels • Pixel size 148 microns • Scintillator Cesium Iodide • Acquisition depth 16 bits • DQE in %, 2 μGy (RQA5) 66% at 0.05 lp/mm • Data transmission < 1.5 sec. preview, <3.5 sec. full image • Thickness 16 mm • Weight 1.6 kg • Max. load capacity 150 kg with patient recumbent • 100 kg with patient standing Battery Lithium ion, rechargeable, exchangeable • Charging time 3 hours in battery charger • Battery operation time Up to 525 images • Up to 3.5 hours during normal use Up to 6 hours in standby mode •Charging location Battery charger • MAX Dynamic Input fields (active field) 42 x 42.6 cm (full format), 30 x 30 cm • (zoom 1), 22 x 22 cm (zoom 2), 15 x 15 cm (zoom 3) Scintillator Cesium iodide • Pixel size 148 microns • Spatial resolution 3.4 lp/mm • Matrix Up to 2840 x 2874 pixels • Acquisition depth 16 bits • DQE >65% (at 0.05 lp/mm) • Modulation depth >63% (at 1 lp/mm) • Anti-scatter grid Stationary, Pb 15:1, 80 lines/cm, focused at • 125 cm removable Tabletop-detector distance 7.3 cm • Five selectable solid state measurement fields • Measurement fields adjusted according to collimation and zoom format • Imaging System Image display < 1.5 sec. preview, <3.5 sec. display • Image storage capacity 50,000 images • Image size Approx. 9 MB • 49 Turnover Workbook | Luminos Agile Max - VE10 and Higher 8. Troubleshooting 8.1 System Movements and Functions Notes It is possible to disable system movements and functions by using the Disable button in the Set Up tab on the 3D overhead tube. Some points to remember are: When not activated, the icon will e gray and black. All • system movements should be possible. When active, the icon will be backlit. All buttons on the K • tube, wall bucky and table are disabled and no system movement is possible. 8.2 SID Tracking SID Tracking, or Source to Image Distance Tracking, allows the user to change the height of the all buck or table and have the tube follow to maintain the SID. This can be done at the table or wall bucky. When SID Tracking is active, the icon will be backlit. Some conditions must be met for SID Tracking to function: Wall Bucky The wall bucky is tiltable and is tilted to 90 degrees (horizontal) • X-ray tube must be detented in X and Y planes above tilted wall bucky • X-ray tube angulation must be 0 degrees, +/- 3 degrees. • SID must be greater than 33 inches • The detector must be inserted into the wall bucky tray • Table Bucky The X-ray tube is in detent to the table bucky grid • X-ray tube angulation is 0 degrees, +/- 3 degrees • SID is greater than 33 inches • The detector must be inserted into the table bucky tray • If these conditions cannot be or have not been fulfilled when the SID Tracking button is pressed, then the icon will appear dark pink. This indicates that SID Tracking is lost. The function is active, but not all of the requirements for tracking have been met. HO 50 Turnover Workbook | Luminos Agile Max - VE10 and Higher Here are some things to look for when SID Tracking is lost: Notes 1. If at the wall bucky, make sure the bucky is horizontal and not tilted 2. Make sure the X-ray tube is not angled more than 3 degrees 3. If at the table bucky, make sure the table height is not too high or low, meaning the tube cannot maintain an SID greater than 33 inches When it comes to Top Alignment and SID Tracking, the optimal workflow is to fulfill all of the requirements for that function first, then activate the function with the icon. 8.3 Collimation ACSS stands for Automatic Collimator Size Selection. Simply put, this is automatic collimation: when active, you cannot collimate larger than the detector size, but you can collimate smaller. ACSS has a couple of conditions that must be met for it to be active: The bucky tray must be pushed all the way in (table or wall) • The detector must be centered in the table bucky tray in landscape(crosswise) • orientation Key Points 1. When the bucky tray is pushed in, ACSS will be displayed on the LCD display of the tube. This indicates that ACSS is active. 2. If you see ‘Manual” on the tube after pushing the bucky tray in, then ACSS is not active. This is usually a result of not pushing the bucky tray all the way in, or the detector is not centered when in landscape orientation in the table bucky tray. Remember, ACSS only applies to exposures in the table and wall bucky. It does not apply to tabletop exposures. OGPs Each OGP has a set collimation size located within the program parameters. Collimation size will adjust when a different OGP View is selected manually or via the automatic drop down function. 8.4 The Message Field V Ready 182568 The Message Field is the area of the Touch User Interface next to where the system • green “Ready” field is displayed with the check mark, indicating an exposure can be made. This is also the area where system error messages are displayed. • 51 On account of certain regional limitations of sales rights and service availability, we cannot guarantee that all products included in this brochure are available through the Siemens sales organization worldwide. Availability and packaging may vary by country and is subject to change without prior notice. Some/All of the features and products described herein may not be available in the United States. The information in this document contains general technical descriptions of specifications and options as well as standard and optional features which do not always have to be present in individual cases. Local Contact Information Siemens Medical Solutions USA, Inc. Siemens reserves the right to modify the 40 Liberty Blvd. design, packaging, specifications and Malvern, PA 19355-9998 options described herein without prior notice. Please contact your local USA Siemens sales representative for the Telephone: +1-888-826-9702 most current information. siemens.com/healthcare Note: Any technical data contained in Legal Manufacturer this document may vary within defined Siemensstrasse 1 tolerances. Original images always lose a certain amount of detail when Forchheim, Germany 91301 reproduced. Phone: +49 9131 84-4746 siemens.com/healthcare Siemens Healthcare Headquarters Siemens Healthcare GmbH Healthcare Sector Henkestr. 127 91052 Erlangen Germany Phone: +49 9131 84-0 siemens.com/healthcare Published by Siemens Healthcare GmbH · Order No. HOOD05162003017320 · Printed in USA · 0000.x · © Siemens Healthcare GmbH, 2017