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MAMMOMAT Revelation 3D Stereotactic Biopsy Turnover Workbook

MAMMOMAT Revelation 3D Stereotactic Biopsy Turnover Workbook

MAMMOMAT Revelation SIEMENS . Healthineers Encar .. MAMMOMAT Revelation Biopsy Turnover Workbook SIEMENS Healthineers www.usa.siemens.com/education I. Contact Information Summary Welcome to Siemens Healthineers Printed Self-studies • Virtual Education (Offerings & Registration) • Siemens Healthineers is dedicated to helping you get the most out of your investment throughout the entire Workshops & Fellowships • product life cycle and beyond. Our goal is to enable you to take technology further, profitability higher, and patient care to the next level. Find the information, resources, and Visit www.usa.siemens.com/clinicaleducation for more tools you need to get the most out of your recent information regarding the current Siemens investment and stay up-to-date. Clinical Training and Continuing Education portfolio. Visit www.usa.siemens.com/Welcome2Healthcare. Discover. Try. Buy. on webShop Clinical Training and Continuing Education Do you want to “Discover. Try. Buy.” options, accessories, Customer Care Center - Clinical Application Support: and clinical education to make the most of your imaging equipment? Discover images, case studies, Call 1-800-888-7436 and video demonstrations with the latest clinical Troubleshooting assistance applications. Try advanced applications utilizing • Immediate assistance for software free software trials. Buy applications, coils, clinical • applications and workflow issues education, and accessories, conveniently at any time. Visit www.usa.siemens.com/webShop today! Please provide the Functional Location Number when • calling for assistance. Siemens Training Centers Siemens Clinical Education Clinical Education Offerings: Training Center – TDC2 110 Mac Alyson Court Call 1-888-221-8010 (follow the prompts) Cary, NC 27511 Classroom Training (Offerings, Registration • & Scheduling) Educational Symposia • On-site Training • 2 II. Contents I. Contact Information Summary .....................................................................................................................................2 II. Contents ............................................................................................................................................................................3 III Course Description ..........................................................................................................................................................4 III Agenda ................................................................................................................................................................................ 5 Day One ..................................................................................................................................................................................6 System Overview ................................................................................................................................................. 6 Removing Biopsy Unit........................................................................................................................................ 9 Key Hardware Features ....................................................................................................................................10 Calibration (Yearly or when Daily Check fails) ..........................................................................................12 Daily Check .........................................................................................................................................................14 Technologist ........................................................................................................................................................17 2D Biopsy Procedure .........................................................................................................................................19 HD Tomo Biopsy Procedure Job Aid ............................................................................................................ 20 Needle Localization Procedure ......................................................................................................................21 Day Two ................................................................................................................................................................................23 Review and Patient Studies ........................................................................................................................... 23 Day Three .............................................................................................................................................................................24 Review and Patient Studies ........................................................................................................................... 24 Appendix A: Power Failure - Manual Release Options ............................................................................................................ 25 Appendix B: How to Perform a New Biopsy Unit Referencing- Error 7 ................................................................................. 28 3 III Course Description Course Overview: The purpose of this training session is to provide you with the skills and knowledge to operate your system. Course Objectives Upon completion of this course, you will be able to: Power up and activate the MAMMOMAT® Revelation Biopsy Unit • Utilize key hardware features of the MAMMOMAT Revelation Biopsy Unit • Identify and perform the required QC tests for the MAMMOMAT Revelation Biopsy Unit • Perform a Biopsy Procedure • Perform a Needle Localization Procedure • Correctly power off the MAMMOMAT Revelation Biopsy Unit • Learning Materials The following instructional materials are referenced throughout this training session: System Owner Manual Provides the necessary knowledge and expertise to accurately and safely operate the system. Training Workbook Supports the System Owner Manual through “big picture concepts,” examples, stories, interactive exercises, and references to online documentation. This book is yours to keep, so you can write in the book. Step-by-Step These documents provide quick reference tips to aid customers in “just-in-time” learning opportunities. 4 III Agenda Day One Introduction of MAMMOMAT Revelation Biopsy Unit • Attaching the Biopsy Tower • Explanation of the Three Needle Holders and their Usage • Removing the Biopsy Unit • Key Hardware Features • Required QC Tests • Biopsy Procedure 2D and 3D • Perform Simulated Biopsy Procedures • Perform Simulated Needle Localization Procedure • Review ACR Requirements for Radiologists and Technologists • Day Two Review of MAMMOMAT Revelation Biopsy Unit • Review of the AWS and Integrated Control Panel • Review of Required QC Tests • Perform Simulated Biopsy Procedure • Perform Simulated Needle Localization Procedure • Question and Answer Period • Set Up for Biopsy Procedure • Perform Scheduled Biopsy Procedures • Day Three Review of Required QC Tests • Question and Answer Period • Set Up for Biopsy Procedure • Perform Scheduled Biopsy Procedures • 5 Turnover Workbook | MAMMOMAT Revelation Biopsy Day One System Overview Notes Objectives After this session, you will be able to: Power up and activate the MAMMOMAT Revelation Biopsy Unit. • Utilize key hardware features of the MAMMOMAT Revelation Biopsy Unit. • Identify and perform the required QC tests for the MAMMOMAT Revelation Biopsy • Unit.. Switching On/Start-Up The MAMMOMAT® Revelation system is started from the switched off mode. Starting the system from the switched off mode. Press the power ON button on the Control Panel. Once the HIPPA screen appears, • click the OK button. Sign in with your User Name and Password. Please note, the password is case sensitive. This process takes approximately 5-10 minutes to be completed. Wait until the RED • X is gone in lower right corner between the pie and the computer. This means your system has completed start up. Complete the 90 - 90 “Single Touch” activation. For detailed start-up instructions and a visual diagram of the system, please see: Online User Manual located in the Help dropdown of your acquisition • workstation (AWS) 6 Turnover Workbook | MAMMOMAT Revelation Biopsy Attaching the Biopsy Unit Notes Slide biopsy unit over the detector until it engages (clicks) into position • Insert the biopsy unit plug into the port located on the left side of the gantry. • Verify the hand box is plugged into the biopsy unit • Attach the biopsy compression paddle and face shield • SIEMENS wow,thiseers (1 (2) (3 (1) Compression plate (2) Biopsy volume, depending on compression plates Biopsy volume, vertical needle guide appr. 50 mm x 40 mm × 100 mm Biopsy volume, lateral needle guide appr. 50 mm × 40 mm × 60 mm (3) Object Table 7 Turnover Workbook | MAMMOMAT Revelation Biopsy Standard Holder - Vertical . Can be removed for cleaning - Alcohol-based/ cleaners containing hyndrogen peroxide products not permitted . Press black button to remove from Biopsy tower . Must be removed for the tomo scout and any other tomo sequence For safety check the needle holder has to be attached and removed if the AWS requests - before a biopsy examination can be started Mammotome ST - Vertical & Horitzontal Holders (L&R) System Needles Needle holder Designation Gauge (G) Length [mm] Vertical Horizontal Mammotome Vacuum 8, 11, 14 120 Dedicated nee- Dedicated nee- biopsy dle holder die holder Notes 8 Turnover Workbook | MAMMOMAT Revelation Biopsy Removing Biopsy Unit Notes 1. Remove the needle. If necessary, move the swivel arm to the side using the single- touch button. 2. Remove biopsy compression paddle and biopsy face shield. 3. Bring tube head to zero using single-touch button. 4. Unplug biopsy unit cable from the side of the detector. 5. Place hand box on biopsy unit. 6. Press and hold both “unlock” buttons located on the gray handrails of the biopsy unit. Remove biopsy unit and store. Follow Shutdown Procedure for Inspiration Mammography Unit. (1) (2) 9 Turnover Workbook | MAMMOMAT Revelation Biopsy Notes Movement in x direction Movement in y direction Movement in z direction Key Hardware Features Compression Plates 1 2 1. Vertical biopsy approach compression plate: Removable for cleaning/disinfection. Smooth rounded edges for patient comfort. 2. Horizontal biopsy approach compression plate: A thin line on the plastic tray indi- cates the area to be targeted. Removable for cleaning/disinfection. Smooth rounded edges for patient comfort. 10 Turnover Workbook | MAMMOMAT Revelation Biopsy Force Conversion Chart Notes Force in Kilograms (kg) Pounds (lbs.) Newtons (N) 1 2.2 9.81 2 4.4 19.61 3 6.6 29.42 4 8.8 39.23 5 11 49.03 6 13.2 58.84 7 15.4 68.65 8 17.6 78.45 9 19.8 88.26 10 22 98.07 11 24.2 107.87 12 26.4 117.68 13 28.6 127.49 14 30.8 137.29 15 33 147.1 16 35.2 156.91 17 37.4 166.71 18 39.6 176.52 19 41.8 186.33 20 44.1 196.13 11 Turnover Workbook | MAMMOMAT Revelation Biopsy Calibration (Yearly or when Daily Check fails) Notes 1. Attach Biopsy Unit. 2. Click Patient>Biopsy Calibration. 3. Follow on-screen instructions. Open patient Acquisition Calibration Please ensure that no paddle is mounted and the needle is removed from the needle holder. Afterwards press the Move to position button. Move to position Post processing Close patient 4. Click the Move to position button. 5. Attach standard needle holder and insert calibration needle. 6. Acquire Scan. (Do not lift off of exposure button/foot pedal until both images are acquired and the tube returns to the zero position). 7. Follow on-screen instructions. Open patient Acquisition Calibration Please adjust the reference mark with the Ref. Point button if needed, place the target mark to the peak of the calibration needle on the image and press Confirm. Ref. Point Confirm Post processing Close patient 8. Click the Ref. Point button. 12 Turnover Workbook | MAMMOMAT Revelation Biopsy 9. Right-click on the image and select Zoom from point. Left-click on the reference Notes mark in the left image and then the same area on the right image to magnify the ref- erence point. Press the ESC button on the keyboard to deactivate the “Zoom from point.” For more detail and instructions on calibration and daily check, please refer to the operator’s manual pages 19 and 21. 10. Left click on the reference mark on the left image to adjust if needed. Adjust the mark on the right image as well if needed. 11. Click Confirm. 12. Right-click on image and select Home zoom pan. 13. Right-click on image and select Zoom from Point. Left-click on the tip of the needle in the left and right images to magnify. Press the ESC key to deactivate “zoom from point.” 14. Place a target onto the needle tip in both images and hit confirm. 15. Click Move to position. 16. Remove needle. 17. Remove needle holder or override by leaving the calibration needle in place and pushing the override button on the side of the tower. The holder will move to the next calibration position. 18. Proceed in the same way for the second and third stereo pair as shown in the cali- bration window. The reference point won’t be checked again. WH AWS X Calibration has been successfully ended. Please remove the needle from the needleholder if it is still inserted and after that press OK to close the calibration. OK 19. The “Calibration Successfully Ended” box will appear. 20. Click OK. 21. Remove needle and holder. 22. Holder will go to the “Home” position. 13 Turnover Workbook | MAMMOMAT Revelation Biopsy Daily Check Notes 1. Attach the Biopsy Unit. 2. Place pegs into the Biopsy Phantom. 3. Place phantom on the detector with the reference displayed in the hole of the phantom and compress to immobilize phantom. DO NOT try to achieve OpComp. 1 2) 14 Turnover Workbook | MAMMOMAT Revelation Biopsy Notes 4. Register the patient. 5. Choose Daily Biopsy Check located in the “Procedure” dropdown. Change IPPG to Daily Test Biopsy in the Acquisition subtask card. 6. Acquire “Scout” image. Select OK to continue, or New to repeat the exposure. 7. Acquire the scan. Do not release the exposure button. The tube will acquire a -15 degree stereo image and then the tube will move to the +15 degree stereo for other exposure. Once the tube returns to the zero position, you can release the exposure button. 8. Check reference marks by clicking Ref Point. Make adjustments as needed and press the Return key. 9. To magnify images, right-click on the image and select Zoom from Point. Left-click on the “Reference Marks”. Press the ESC key to deactivate the “Zoom from Point” tool. 10. Target the circle that is not within a peg (this is not visible on the top of the phan- tom). If necessary, select “zoom from point”.Click Confirm, a dialog box should appear: “Target is out of Biopsy Range.” Click OK. This verifies that the system is cor- rectly calculating the safety distance. 11. Drag the cursor to the center target position in each image. Click Confirm. 12. Highlight the target numbers (x, y, z in Stereo tab in the subtask card) and verify the correct holder (standard) and needle (calibration) are selected. Click the Trans- mit button. 15 Turnover Workbook | MAMMOMAT Revelation Biopsy 13. Click Transmit then click Yes. Arrows will appear in the Acquisition tab while the Notes holder is moving. Once the holder reaches the target a “Flag” is displayed next to the target on the AWS. 14. Attach standard needle holder and calibration needle. 15. Touch the handbox to zero out. The tip of the needle should not be felt from the bottom of the peg. If an adjustment is needed push the over ride button and adjust the needle by using the handbox. 16 Turnover Workbook | MAMMOMAT Revelation Biopsy 16. Acquire a stereo pair to confirm needle placement within the peg. Notes 17. Record the values displayed on the AWS and hand box in the appropriate place on the QC form. 18. Remove the needle and holder. The system will return to the home position when the study is closed. Weekly Phantom (optional if not ACR accredited) 1. Attach biopsy unit. 2. Register Patient. 3. In Procedure dropdown, choose Biopsy Phantom. 4. Verify OpDose is selected. 5. Compress stereo phantom. 6. Acquire scout image. (If not using the mini stereo phantom, you will have to acquire the image in quadrants.) 7. Score phantom. 8. End procedure and document on QC form. ACR Requirements Radiologists must be in compliance with ACR guidelines for interpreting mammography studies. Surgeons must review the mammography findings with an MQSA qualified Radiologist. Radiologist/Surgeon Initially, three hours of Category 1 CME didactic instruction in stereotactically guided biopsy. Three supervised stereotactic procedures under qualified physician. • Completion of a residency or fellowship program that includes instruction in • stereotactic breast needle procedures. At least twelve stereotactic-guided biopsies per year are required by ACR for • continued competency. Three hours of Category 1 CME in stereotactically guided breast biopsy every three • years is required by ACR. Technologist Initial three hours of Category A continuing education units in stereotactic-guided breast biopsy. Documentation of five “hands on” procedures under the guidance of a qualified • technologist or a manufacturer’s application specialist. Participation in at least twelve stereotactic-guided breast biopsies per year. • ACR Accreditation for stereotactic biopsy is voluntary at this time. Please contact the ACR for full details and any updates or changes. 17 Turnover Workbook | MAMMOMAT Revelation Biopsy Radiologic Technologist’s QC QC Text Description Frequency Daily before 1. Localization Accuracy Test Verifies system alignment and performance (procedure varies by manufacturer and system type) patient exams 2. Darkroom Cleanliness Minimizes artifacts on film images by maintaining the (NA if digital used) cleanest possible conditions in the darkroom Daily 3. Processor QC (NA if digital used) Ensures consistent performance of the film processor Daily Ensures that film density, contrast, uniformity, and image 4. Phantom Images quality of the X-ray imaging system are optimal Weekly Screen Cleanliness Ensures that cassettes and screens are free of dust and 5. (NA if digital used) dirt particles that may degrade image quality or mimic Weekly calcifications Viewboxes and 6. Viewing Conditions Ensures that the viewboxes and viewing conditions are (if film used) optimized and maintained at optimal levels Weekly Hard-Copy Output Quality Ensures that the quality of hard-copy output is consistent 7. (if hard-copy produced from over time and matches the gray scales presented on the CRT Monthly digital data) monitor Ensures that the mammography X-ray system and, if 8. Visual Checklist applicable, the digital imaging system are working properly and that the mechanical rigidity and stability of the system Monthly are optimal Analysis of Fixer Retention in Film Determines the quantity of residual fixer (hypo) in processed 9. (NA if digital used) film as an indicator of keeping quality Quarterly 10. Compression Ensures that the X-ray imaging system can provide adequate compression in the manual and automatic powered mode Semiannually Determines the number and causes of repeat patient 11. Repeat Analysis exposures and identifies ways to improve efficiency, reduce Semiannually patient breast dose, and cut costs 12. Screen-Film Contact Ensures that optimum contact is maintained between the (NA if digital used) screen and the film in each cassette Semiannually 13. Darkroom Fog Ensures that darkroom safelights and other light sources (NA if digital is used) inside and outside of the darkroom do not fog film Semiannually Zero Alignment Test (If required by Verifies that zero coordinate is accurate Before each 14. manufacturer) patient Any additional tests required by As required by 15. manufacturer manufacturer 18 Turnover Workbook | MAMMOMAT Revelation Biopsy 2D Biopsy Procedure Notes 1. Attach Biopsy Unit and paddle. 2. Register Patient. 3. Procedure may not automatically populate from RIS.If needed, manually select the procedure from the “Procedure” drop down. Choose correct procedure. If the site does not have a mapped Stereo procedure, manually select the procedure from the “Procedure” dropdown. Choose correct procedure.. 4. Double click the Scout icon. (May take a minute to activate). 5. Position the Patient. 6. Use OpDose. The compression force must display at least 15 N on tube stand. Sie- mens recommends compression of 40-50 N during a stereo procedure. 7. Acquire scout image. Click OK if scout is acceptable. Click New to repeat scout. 8. Acquire the scan. 9. Check reference marks by clicking Ref Point and adjusting as needed. Click Confirm. 10. Highlight the target to be transmitted. 11. Verify needle and needle holder to be used. Click Transmit. Blue arrows will appear in the Biopsy tab while the holder is moving. Once the holder reaches the target, a Flag is displayed next to the selected target on the AWS. 12. Attach needle holder. Zero out the hand box by pressing any button on the hand box. 13. To mount biopsy device, verify needle is in the Cocked position and move tube head out of the way by pushing and holding the Single Touch button. As a precaution: push the override button on the side of the tower and raise the “Z” coordinate on the Hand Box to a safe position until the radiologist is ready to insert. 14. Lower biopsy needle close to the skin to indicate where to inject the Lidocaine. Bring “Z” and tube back to the zero position. 15. Acquire stereo images. 16. Perform biopsy and acquire the InSpect image. 17. Deploy the clip per vendor recommendations and acquire clip placement image. 18. Move tube head out of the way, remove biopsy device, and remove needle holder. 19. Release compression, remove Patient. Release compression then remove the patient. When the message Do you want to keep the current Compression Group? appears, select Yes. Perform post-procedure 2D imaging. Close the patient at the AWS. 19 Tomo Biopsy Procedure Notes 1. Attach Biopsy Unit and paddle. Make sure that Show Virtual Paddle is selected. Select View > Show Virtual Paddle Hole. 2. Register Patient. 3. Procedure may not automatically populate from RIS. If needed, manually select the procedure from the “Procedure” drop down. Choose correct procedure. 4. Double-click the Tomo Scout icon. (May take a moment to activate) 5. Position the Patient. 6. Use OpDose. The compression force must display at least 15 N on tube stand. We “recommend” compression of 40-50 N during a stereo procedure. 7. Acquire Tomo scout image. Make sure needle holder is not attached to the biopsy tower. 8. Scroll through the slices to make sure the region of interest for the biopsy examination is included. Click OK when the region of interest for biopsy is within the possible biopsy volume – or – click New if the region of interest is not completely visible in the slices. 9. Check reference marks by clicking Ref Point and adjusting as needed. Click Confirm. This step is not necessary if the reference marks do not need to be adjusted. If you are not adjusting the reference marks, when OK is clicked, system switches to the first view. If you don’t need to adjust the reference marks, click the slices icon in the biopsy subtask card to get back to slices. 10. Mark the biopsy target point in the tomo slices with a left mouse click. The target point can only be placed in the tomo slices, not in the 2D scout image. Choose the slice were the lesion is displayed sharpest. Click Confirm. Multiple targets can be made in multiple slices. 11. Highlight the target to be transmitted. 12. Verify needle and needle holder to be used. Click Transmit. Blue arrows will appear in the biopsy tab while the holder is moving. Once the holder reaches the target, a flag is displayed next to the selected target on the AWS. 13. Attach needle holder. Zero out the hand box by pressing any button on the hand box. 14. To mount biopsy device, verify needle is in the “cocked” position and move tube head out of the way by pushing and holding the Single Touch button, -OR- by pushing the appropriate arrow button. As a precaution: push the override button on the side of the tower and raise the “Z” coordinate on the Hand Box to a safe position until the radiologist is ready to insert. 15. Lower biopsy needle close to the skin to indicate where to inject the Lidocaine. Bring “Z” and tube back to the zero position. 16. Acquire stereo images if needed. 17. NOTE: If additional targeting needs to be performed, a new TOMO scout cannot be performed unless the holder is removed and the tower is in the HOME position. The HOME position is achieved if the Z is raised to its highest point and the Y position is all the way back. Otherwise, any new targets can only be made on the Stereo pair. 18. Perform biopsy and acquire the InSpect image. 19. Deploy the clip per vendor recommendations and acquire clip placement image. 20. Move tube head out of the way, remove biopsy device, and remove needle holder. 21. Release compression, remove patient. When the message “Do you want to keep the current compression group?” displays, select Yes. Perform post-procedure 2D imaging. 22. Close Patient at AWS. Turnover Workbook | MAMMOMAT Revelation Biopsy Needle Localization Procedure Notes 1. Attach Biopsy Unit, Paddle, Standard Needle Holder, and Needle loc “specific” Bushings. 2. Register Patient. 3. Procedure may not automatically populate from RIS. To manually select the proce- dure, click the Procedure dropdown menu, and select the correct procedure. 4. Double click Scout icon. (May take a minute to activate.) 5. Position the Patient. 6. Use OpDose. The compression force must display at least 30 N on tube stand. 7. Acquire scout image. Click OK if scout acceptable. 8. Click New to repeat scout. 9. Acquire the scan. 10. Check reference marks and select Confirm. 11. Place targets on area to biopsied in stereo pair. Click Confirm. 12. Highlight the target to be transmitted, click Transmit. 13. Verify needle and needle holder to be used. Acknowledge the pop up box by select- ing Yes or No. 14. Inject Lidocaine if desired. 15. Insert Localization needle. 16. Acquire scan. 17. Adjust Z value if needed. 18. Deploy wire and remove needle. 19. Slip wire out of bushings. 20. Press Override button. Manually raise the Z. 21. Release compression, remove Patient. 22. Close Patient at AWS. Needle holder will move to home position. 21 Turnover Workbook | MAMMOMAT Revelation Biopsy Day One Excercises Notes Complete the following exercises. Exercise 1: Set the system up to perform a 2D biopsy utilizing the Vertical and Horizontal Needle holders. Exercise 2: Perform stereo in CC projection and change to LM projection mid exam. Exercise 3: Perform a vertical approach tomo biopsy on a phantom. Knowledge Check How many pegs are targeted during Daily Biopsy Check? 22 Turnover Workbook | MAMMOMAT Revelation Biopsy Day Two Review and Patient Studies Notes Objectives After this session, you will be able to: 1. Perform QC Tests. 2. Perform/Simulate Biopsy Procedures. 3. Perform/Simulate Needle Localization Procedures. 23 Turnover Workbook | MAMMOMAT Revelation Biopsy Day Three Review and Patient Studies Notes Objectives After this session, you will be able to: 1. Perform QC Tests. 2. Perform/Simulate Biopsy Procedures. 3. Perform/Simulate Needle Localization Procedures. 4. Question and Answer Period. Cleaning All parts of the unit that come into contact with the Patient must be cleaned prior to examination. Clean the dust from the ventilation slots on the detector on a regular basis. Caution: Using incorrect cleaning agents can accelerate the aging process of the plastics. Caution: Cleaning agents must not penetrate into the equipment. 24 Turnover Workbook | MAMMOMAT Revelation Biopsy Appendix A: Power Failure - Manual Release Options 25 Turnover Workbook | MAMMOMAT Revelation Biopsy System overview 1 1.3 Solution to the problem/Instructions In the event of a power failure or if movement is blocked during a biopsy examination, release the patient as follows: 1.3.1 Unlocking the device (1) >3 cm If the distance between the compression plate and the positioned biopsy unit is greater than 3 cm, then: (3) Firmly press the compression emergency unlocking device (3). Compression is mechanically unlocked, compression plate can be pushed up. The patient may be removed from the biopsy unit. 1.3.2 Unlocking the device (2) <3 cm If the distance between the compression plate and the positioned biopsy unit is less than 3 cm, then you must first move the needle positioning part up: MAMMOMAT Revelation | VC10 or higher 25 Print No. XPW7-340G.621.03.02.02 26 Turnover Workbook | MAMMOMAT Revelation Biopsy 1 System overview (4) 1 Using a stylus, open the small cover (4) at the top of the needle positioning part. (6) CO (5) 2 Using a ballpoint pen (6), for example, turn the wheel (5) clockwise. The needle positioning part will move upward. (3) 3 Now firmly press the compression emergency unlocking device (3). Compression is mechanically unlocked, compression plate can be pushed up. The patient may be removed from the biopsy unit. If manual movement of the needle positioning part is necessary, note that 1 the needle slide can block at the upper end. In this case use the hand wheel to move the slide to a lower position. Closing/opening the hand wheel cover to manually move the needle positioning part into the upper position is not possible. 26 Breast Biopsy (Option) | Operator Manual Print No. XPW7-340G.621.03.02.02 27 Turnover Workbook | MAMMOMAT Revelation Biopsy Appendix B: How to Perform a New Biopsy Unit Referencing- Error 7 28 Turnover Workbook | MAMMOMAT Revelation Biopsy How to Perform a New Biopsy Unit Referencing- Error 7 MAMMOMAT Revelation If the biopsy unit is mounted on the MAMMOMAT Revelation, the needle holder automatically moves through the reference positions. The referencing movement of the needle holder must not be interrupted. If a malfunction occurs during the referencing movement, the following window appears: WH AWS X x The Biopsy Unit encountered a hardware problem during self test. Error: 7. A new Biopsy Unit referencing is required. Please remove needle and paddle and push OK to open the user interface for Biopsy Unit referencing. After successful referencing the system should be restarted. OK 1. Click on OK. OK 2. The following window is displayed: Biopsy Referencing Tool - Microsoft Internet Explorer provided by Siemens Medical So ... File Edit View Tools Help Back - DEÀ Search Favorites Address | C:\AWSutils\loader.htm Go Links >> To help protect your security, Internet Explorer has restricted this file from showing active content that could x access your computer. Click here for option Allow Blocked Content ... An error has occured while trying to access Biopsy referencing p: What's the Risk? Information Bar Help SIEMENS Healthineers siemens.com/healthineers 29 Turnover Workbook | MAMMOMAT Revelation Biopsy Job Aid | How to Add a New 2D Procedure Effective Date: 04/13/2018 | 3. Select the upper line "To help protect..." To help protect your secunty, Internet Explo access your computer Click here for option 4. Open the popup menu (right mouse button) and select Allow Blocked Content. Allow Blocked Content ... What's the Risk? Information Bar Help 5. The following window is displayed: Security Warning Allowing active content such as script and ActiveX controls can be useful. out active content might also harm your computer. Are you sure you want to let this file run active content? Yes No 6. Click Yes Yes 7. The following window is displayed: Zigma Service Modul - Microsoft Internet Explorer provided by Siemens AG Medical Solutions Zigma Webserver Page sent at 10:37:35 07.08.2009 System Version VCOOD State E STATE BLOCKED Biopsy Service Please check following: Biopsy is plugged - System is in state where movements (compression unit, rotation, ... ) are possible No paddle mounted No obstacle on the biopsy table Start Referecing 8. Follow the instructions for manual assignment of the needle holder reference position. 30 Turnover Workbook | MAMMOMAT Revelation Biopsy Job Aid | How to Add a New 2D Procedure Effective Date: 04/13/2018 | 9. Click the Start Referecing icon. Start Referecing The referencing of the needle holder is started. The needle holder automatically moves through several positions. The needle holder should stop moving in the upper left-hand position. 10. The following window is displayed: http://zigmamu/biopsy/aws_wait_referencing.htm - Microsoft Internet Explorer provided by Siem ... [ x] Zigma Webserver Page sent at 10:39:01 07.08.2009 System Version VCOOD State E STATE BLOCKED Back to Home Service Mode Ok: confirm the Reference Position. The needle guide should be in the top left inside position Continue: Reference Position is not ok Retry: Move to the reference position again OK Continue Retry 11. Click Continue if the needle holder is not located in the upper left position OR Continue 12. Click OK if the needle holder is located in the upper left position. OK 13. The referencing of the needle holder was successful. The following window is displayed: #]Zigma Service Modul - Microsoft Internet Explorer provided by Siemens AG Medical Solutions Zigma Webserver Page sent at 10:42:53 07.08.2009 System Version VC00D State E STATE BLOCKED Back to Home Referencing done! 14. Click the right button to close the window and the application. x 15. The biopsy unit is ready for operation. 31 Turnover Workbook | MAMMOMAT Revelation Biopsy Job Aid | How to Add a New 2D Procedure Effective Date: 04/13/2018 | 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's 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. Certain products, product related claims or functionalities (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 ………………………………………………………… Siemens Healthineers Headquarters Siemens Healthcare GmbH Henkestr. 127 91052 Erlangen, Germany Telephone: +49 9131 84-0 siemens.com/healthineers 32 Turnover Workbook | MAMMOMAT Revelation Biopsy Notes 33 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. HOOD05162003017835 / Eff Date 6/14/19 · Printed in USA · ©Siemens Healthcare GmbH, 2017

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